The Surgeon Minute

Breast Augmentation with Fat Grafting

Breast Augmentation with Fat Grafting

Fat gets a bit of a bum rap, but not anymore when it comes to breast augmentation and plastic surgery. Vilified by the media, we aren’t supposed to eat it and we aren’t supposed to have any on our body. This is unfortunate since fat = volume, and volume is what delivers a youthful contour to the face and body. So, bottom line, fat (in the proper amount) is our friend!

When plastic surgeons remove fat from one area to be used elsewhere for volume, the key is to place it strategically. The process of removing the fat from one area of your body where, perhaps, you have more than you’d like to another is called fat grafting. Becoming a standard practice in most facelifts and causing the exponential rise in buttock augmentations, fat grafting can also be a great tool in breast augmentation. Dr. Louis Bucky of Philadelphia, PA discusses fat grafting to the breast and how 3D imaging can help a patient visualize the ways in which fat grafting will improve their results.

Are You a Candidate for Fat Grafting to the Breast?

Although many in the industry – including breast implant manufacturers – were concerned that fat grafting to the breast was going to replace breast implants when it first became popular over a decade ago, there is really only a select group of patients who are a viable candidate for using fat alone to augment the breasts. “The vast majority of patients still do well with breast implants for their core volume,” explains Dr. Bucky.

For him, the beauty of fat grafting to the breasts is it can make a patient’s breast augmentation result much better. An ideal candidate for fat grating to the breast is:

  • A patient with a thin breast envelope, who doesn’t have a lot of breast tissue, but still wants a natural looking result. Fat grafting helps to mask the implant in really thin patients.
  • A patient with breast asymmetry is a great candidate for fat grafting to the breast. In the past, a surgeon would use a larger implant on the small side, but this could be problematic since most larger implants are also wider. Today, instead of different sized implants, surgeons simply use fat to enhance the smaller side.
  • A patient with cleavage issues that can’t be improved with an implant. A lot of patients today desire upper pole fullness. This is true for both breast augmentation and breast lift patients. Fat is an excellent way for achieving this look.

Fat grafting to the breast before and after.

Bottom line, fat grafting to the breast gives the surgeon another set of tools for delivering an individual patient’s desired outcome. And better yet, fat is natural and it lasts. Although there will be a certain amount of attrition, 60% of it stays. As Dr. Bucky tells his patients: What’s there in 3 months will be there for years.

Where Do You Get the Fat?

One of the main selling points for fat grafting is that it’s receiving two procedures in one. Patients have fat removed from their abdomen, butt or thighs – where it may be unwanted – and add it to their breasts where they do want it. It’s a body contouring procedure and a breast augmentation in one fell swoop. However, if you are a very thin patient who, as we already discussed, is an ideal candidate for fat grafting to the breast, where do you get the fat?

With very thin patients, Bucky simply harvests a little bit of fat from multiple areas instead of taking a lot from one area. This is a good way to get enough volume to work with the breasts because in the very small, thin patient, “small amounts of fat can make a big difference.”

Fat for grafting.

Combing this fat with a breast implant is not a more complicated procedure. In fact, today, it’s very routine. Fat grafting to the breast will add to your total recovery time because there is a donor site for the fat removal that will be sore. This won’t lengthen the time of your convalescence or immobility, it will just lengthen the time of any possible discomfort.

How Does 3D Imaging Help?

Bucky is a huge fan of 3D imaging. “We’re very fortunate to have 3D imaging as part of our consultation.” He finds that it really helps patients to understand the benefit of fat grafting with their breast augmentation because it can actually show patients what they would like with implants and fat versus implants alone. “I think any plastic surgeon who utilizes new techniques needs to be able to show a patient what they’re going to look like,” says Bucky. When the patient can see the end result, she is more willing to take that leap of faith. With 3D imaging, the patient’s, “anxiety is less which means my anxiety is less.”

Dr. Lou Bucky fat grafting before and after.

Furthermore, a more predictable outcome leads to higher patient satisfaction. “I think imaging is critical to patient consultation,” explains Bucky. “In my mind, the best use of imaging is to promise a little less and then deliver a little more.” He will typically use the image to present a result on the less dramatic side so that the patient can see where things are going, but then deliver a result that is much better than promised. “I never want a patient to be disappointed.”

Patients want to know 3 things when they come in for a breast augmentation consultation:

  • What they’re going to look like after surgery
  • If their surgeon has ever operated on anyone like them and what their results looked like
  • That their surgeon is going to take care of them

With the proper credentials and experience, board certified plastic surgeons can utilize your own fat – tissue that lasts – to enhance and finesse breast augmentation, with or without implants depending on the patient.

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