Mr Allan Kalus answers frequently asked questions on Breast Enlargement with Fat Transfer.
Increasing breast size by transferring your own fat is now a reality. If your breasts are lacking in volume and you have some excess fatty tissue available (e.g. in your thighs, hips or abdomen) it is now possible to transfer the excess fat into your breasts in an operative procedure which can be done as a Day Case. Breast augmentation by fat grafting is now an alternative to using breast implants for many women.
- Am I a suitable candidate for breast enlargement by fat grafting?
If you desire a modest increase in breast size while retaining a completely natural look and feel to your breasts then fat grafting is your best option. If your desire is for extremely large breasts with excessive fullness in the upper pole then this can only be achieved with breast implants.
- By how much will my breasts increase in size?
Usually, at least a 1 cup size increase in breast volume is obtained with fat grafting. Occasionally 2 cup sizes (or even more) can be obtained but this depends on the amount of fat available and whether you are able to gain weight following the procedure.
- What percentage of the grafted fat survives?
This will depend on the technique the surgeon uses. Fat graft survival is increased by harvesting the fat under low pressure (rather than the high pressure used for ordinary liposuction). The harvested fat should then be washed to remove the blood and other debris. The excess fluid and debris are then separated either by allowing the fat to “settle” by standing for a time, or by gentle centrifugation. For best survival the fat should then be injected withsmall syringes using a technique of multiple injections where the fat is dispersed evenly throughout the breast. This allows each group of fat cells to have the best chance to establish connection with vascular tissue and to survive.
Using these techniques it is common for at least 80% of the injected fat to survive.
What can I do to enhance survival and growth of the grafted fat cells?
Fat cells are sensitive to the hormone insulin. Therefore a high carbohydrate diet for a few weeks following fat grafting will raise your blood insulin levels and give the fat cells their best chance to survive and grow.
- Will the size of my breasts vary with weight fluctuations?
Yes, the fat in your breasts will behave just like the fat in other parts of your body. So, if you gain weight, you can expect your breast size to increase. On the other hand, if you were to lose weight, then your breasts could diminish in size.
- How many times can the procedure be performed?
Most women are happy with the result after only 1 breast grafting procedure. A second fat grafting procedure can of course be performed and often the fat take seems even better as the scaffolding has already been created.
- What recovery can I expect after fat grafting?
You will be able to go home a few hours after your surgery. Your breasts will be swollen but not particularly bruised or painful. You can expect the swelling to decrease for the first 2 weeks, after which your breast size should be stable. Having a high carbohydrate diet will increase your blood insulin levels and ensure the maximum survival and growth of your new breast fat.
Your donor areas will be a little bruised and you will be more comfortable wearing a supportive girdle for about 6 weeks.
You should be able to drive after 2-3 days but should avoid strenuous exercise for a month.
- Are stem cells used?
Yes, numerous stem cells are present around the fat cells that are grafted. These stem cells are much smaller than the fat cells and have an even higher rate of survival. These stem cells have the ability to differentiate into fat cells in the future.
- Is fat grafting to the breasts safe?
Yes it is. For many years surgeons worried about the possibility of fat transfer to the breast resulting in lumpiness but this has been shown either not to occur or to be very rare. If a lump does develop then you will need to have a mammogram so that the radiologist can differentiate between a lump of fat and breast cancer. There has never been a case of breast cancer attributed to fat grafting. This is not surprising as breast cancers develop in the breast duct tissue not in the breast fat. If you are over 40y it is useful to have a mammogram done before surgery as a baseline.
- Can I swap my old breast implants for my own fat?
Yes this is becoming an increasingly popular option. Silicone gel breast implants in particular are known to have a high incidence of rupture and this incidence increases with time. Rupture of the implant may be present and undetectable other than by a breast MRI. Many women are choosing to have their silicone gel breast implants removed and the volume replaced with their own fat. The results are excellent.
- What if I do not have much fat available and desire at least a 2 cup size increase in breast volume?
In this situation your safest and best option is to have breast augmentation using smooth walled saline-filled implants inserted behind the pectoral muscle. Placing the implant behind the pectoral muscle dramatically reduces the risk of capsule contracture (breast hardening). Placing the implant behind the muscle also makes it difficult to detect a difference between the various kinds of implants (silicone v saline, anatomical v round). A smooth, round, saline implant placed behind the pectoral muscle results in a beautifully shaped breast that is soft and natural to the feel. As the implant is filled with salt water rupture is much less of a concern.
How we can help…
Breast augmentation using your own fat is the fastest growing procedure at Avenue Plastic Surgery Melbourne. We were the first in Melbourne to offer this procedure and now have years of experience. Contact us for a personalised consultation, where you can see our library of before and after images, and learn if this procedure is right for you.
You can also read more about how we perform the procedure here.