Breast Augmentation with Fat Transfer
Varies based on volume of fat being transferred and
number of areas being liposuctioned
Who Is a Good Candidate?
Patients who do not want to have breast implants and
only want a modest size increase of about 1 cup are
good candidates for breast augmentation using their
own fat. In addition to having enough breast tissue to graft the fat into, patients must have enough fat on their bodies to remove and graft into their breasts. There is no long term maintenance required, unlike in the case of implants which will likely need to be switched out during a patient's lifetime, and you see both an improvement in areas where fat is taken as well as an increase in breast size. During your consultation, you will discuss areas where you want fat removed, and what your sizing goals are. Dr. Kayan and her team will try and give you a realistic idea of what results can be achieved, as well as give you an example of the corresponding implant size you would end up at after your fat transfer surgery. Some patients will choose to undergo more than one round of fat grafting to the breasts if their goal size cannot be reached with a single surgery. If multiple procedures are planned, the time between surgeries is usually 3-6 months at a minimum.
What is Fat Grafting?
Fat grafting is the term used to describe removal of fat from one part of the body and transplantation of this fat into another part of the body. Fat from one patient can only be used on that same patient, and cannot be "donated" to another patient for fat grafting. The procedure itself consists of transfer of very small "packets" or aliquots of fat into the recipient tissue. The principle is similar to that of a skin graft, as the small "packets" of fat receive their initial nutrition for staying alive from the surrouding tissues, and eventually survive by your body actually establishing and growing blood vessels to the new fat. In general, 50-75% of the fat transferred will stay, so if 100 ml of fat is transferred to a certain part of the body, a patient can expect to retain 50-75 ml at most after they are completely healed.
Fat transfer is done under general anesthesia at an outpatient surgery center. The surgery takes between 1 1/2-3 hours, depending on how many areas are being liposuctioned, as well as the volume of fat being transferred. Several 3-4 mm incisions are made in the areas to be liposuctioned, then a solution consisting of local anesthetic and epinephrine to shrink the blood vessels and help with pain post operatively is infused into your tissues, and long thin metal rods called cannulas are used to remove fat into a sterile container. The fat is collected in this container, rinsed, and loaded into small syringes to be injected into your breasts via a 2-3 mm incision on the underside of each breast. Your incisions are closed with dissolvable sutures and dressings, and you will be wrapped in a compression garment.
You may remove all dressings and garments and take a shower after 24-48 hours. There are no stitches that need to be removed. Patients will wear the compression garment(s) 24/7 for 4-6 weeks to help with swelling from the liposuctioned areas. No compression or tight clothing should be worn over the breasts as pressure on the fat may restrict blood flow. You will be quite bruised and swollen for about 1-2 weeks. Sometimes the swelling in the fat injection sites and the liposuction sites can remain on and off for several months. In general, after the first 4-6 weeks most of the acute swelling in your breasts will go away, but it takes a full 3 months for the breasts to settle at their final size after all the non-viable fat is reabsorbed by your body.