The Surgeon Minute

Breast Implants with Fat, the Newest Trend in Breast Surgery

Breast Implants with Fat, the Newest Trend in Breast Surgery

Surgeons are now combining a patient’s own fat with breast implants – “It’s the best of both worlds,” says Dr. Dan Del Vecchio, a board certified plastic surgeon from Boston.

With the advent of fat grafting to the breast and the reliability of being able to take a person’s fat and transplant it; the question now is, where does fat fit into breast augmentation surgery?  Combining these two relatively new technologies is called Composite Breast Augmentation. There’s a lot to learn on this subject, so we turned to Dr. Dan Del Vecchio, a leader in the field of fat grafting to answer our questions.

The Plastic Surgery Channel was able to catch up with Dr. Del Vecchio while he was speaking at the annual American Society of Aesthetic Plastic Surgery (ASAPS) convention in Vancouver, Canada.  Del Vecchio was a key speaker at the event on the subject of fat grafting and fat harvesting techniques in the field of plastic surgery. Below is his interview with

By Dan Del Vecchio, MD
and Carolynn Grimes

PSC Interviews a Leader in Fat Grafting Procedures

PSC- What can you tell us about Composite Breast Augmentation?

Del Vecchio- “Composite Breast Augmentation is using both fat and implants to provide the best cosmetic result for patients. The gold standard in breast augmentation is the breast implant and it has been for the Composite Breast Augmentationpast 50 years and it always will be. However, one of the issues with implants is that they are often limited by the soft tissue that covers the implant.  So in terms of size, you can only put in a certain size breast implant based on the amount of soft tissue a patient has.”

“There are limitations with fat grafting as well; there are size limitations.  You can’t get a breast to project anteriorly with fat as you can with an implant.”

“The concept of Composite Breast Augmentation is being aware that breast implants and fat have limitations. Taking the best of both and combining the core volume projection of an implant and covering it with the natural look and feel of fat, that’s composite breast augmentation.”

PSC- Can you describe the procedure?

Del Vecchio- “In Composite Breast Augmentation, an implant is inserted as it typically is and then after liposuction is performed, the fat is  processed and then injected to cover the breast implant to give a natural look and feel.”

PSC- Who would be a good candidate for this procedure?

Del Vecchio- “Composite Breast Augmentation is especially useful in thin patients who have a relative scarcity of soft tissue in their breasts that would be insufficient to cover an implant.  However, even in thin patients, it’s often possible to take a significant amount of fat and cover the implants and give them a more natural look.

PSC- Does this procedure eliminate the need to put breast implants under the muscle tissue?

Del Vecchio- “Historically, breast implants were placed over the muscle. The move to put them under the muscle was stimulated by an inability to cover the implant with soft tissue, but now that we can put fat over the implant we’re liberated from the need to put implants under the muscle. Fat and implants together, provide more versatility, especially in patients who are more concerned about animation deformities and people who are athletic. Now we can put the implant over the muscle and then put fat over the implant.”

PSC- How does a person know which breast augmentation procedure would be best for them?

Del Vecchio- “One way to clarify and simplify this is to categorize breast augmentation into three groups.”

“There are women who are happy with their breasts shape and they have adequate amounts of soft tissue, but just want to be bigger.  For those patients, breast implants alone will always be the number one choice.”

“Then, there are women who don’t want implants. There are 40 million women in the United States who buy padded bras every year. That’s a testament to the fact that there are women who wished there breast were bigger but don’t want implants. For those patients, augmentation with fat only may be an option.”

“For everyone else, Composite Breast Augmentation is a viable option.”

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