Ask Dr. Pane: Can you do a fat transfer to the breast as opposed to implants?

For many women, breasts play a major role in their perception of how others see them and their own femininity. Breasts that are too large can lead to back problems and other medical issues, while breasts that are too small are often viewed as unattractive, less appealing, or less “womanly.” Cosmetic surgery has come a long way in helping women achieve the bustline which best suits their personal ideals for beauty and their best selves as humans and women. One example of this is the legion of advances in the field of breast augmentation surgery, which led to this question in a recent Instagram Live session with our founder and Chief Medical Officer, Dr. Thomas A. Pane. Many viewers asked variants of this question, which only showcases the interest people have in breast augmentation technology and techniques. The question was, “Can you do a fat transfer to the breast as opposed to implants?”

Dr. Pane’s answer to this was a short, unequivocal “Yes.” Atlantic Coast Aesthetics has been offering and performing fat transfer augmentation to the breasts for many years. At first, people were afraid of this procedure because of concerns that radiologists would see abnormalities within the breast and be unable to differentiate between augmented fatty tissue and potential cancer warning signs during mammograms and other diagnostic tests. Radiologists quickly demonstrated this was not the case. If the fat does unusual things such as clumping or dispersing in unexpected ways, it’s going to look different than indications of breast cancer.

The obvious advantage of doing a fat transfer to the breast is that you’re really just adding in more of what the breast is already composed of. This makes for a perfectly natural shape and feel with minimal scarring, something many patients find desirable. However, Dr. Pane stressed, successful fat transfer depends on the patient having the correct anatomy to accept the procedure and get optimal results. A little looseness in the skin of the breast would be optimal, as would patients who prefer a breast curve that sits lower and presents a more natural profile. Patients with naturally high-set breasts are more difficult, and those who want the resulting breast tissue to sit higher on the chest without the natural curve on the underside of the breast is all but impossible with fat transfer. This is because fat, being mostly water, assumes a teardrop shape when acted upon by gravity. You’re not going to get the full lift like you can with some types of implants.

One of the reasons for this is because of how a fat transfer is done because of how the implant is placed. Fat transfer requires very small incisions and thus smaller scars, versus an implant. While this limits the scarring, it also impacts the ways in which the tissues and the overall shape of the breast can be sculpted. It is possible that in the future a workaround for this may be found, but for now, a fat transfer does have some limitations.

There is no one-size-fits-all answer to this particular issue, even for people who have tighter skin. There are ways to work around this for patients with firmer skin, and although ACA doesn’t offer them, some cosmetic surgeons do. One of these involves putting devices on the breasts to actually stretch the skin and make it a bit looser, allowing more flexibility in the fat transfer. Dr. Pane stresses that this is not something that is for everyone; it is a very patient-intensive procedure. However, although stretching devices are not on the table with ACA, Dr. Pane observes that there are some other things which can be done surgically, depending on the overall build and anatomy of the individual patient.

One final point to consider, Dr. Pane says, is just how much fat is really added to the breast tissue. “In my experience, you have to put more fat in than you think you’ll need because some of that does seem to absorb. There are rare issues where sometimes people can get a little cyst or a little fluid that needs to get needled, something like that. [These complications are] a little bit more [common] than with BBL for some reason, but it’s still a very low [risk] procedure.” A fat transfer doesn’t have to be changed, taken out, etc. unlike an implant. A certain percentage of patients get implant changes at 5, 6, 7, 8, 10 years. These studies take ALL causes and don’t factor reasons for the change into the breakdown of time between implant changes. Pregnancy, gain/loss can impact the anatomy and necessitate a change, but there’s no timer on when it should be removed or change. With silicone implants, the FDA officially recommends MRI screenings at 3 years, but no one really knows if it’s necessary or an abundance of caution. If you feel fine and there is no evidence of problems, then you’re almost certainly okay.

If you have a question about any facet of cosmetic surgery, Dr. Pane and the staff of Atlantic Coast Aesthetics are always happy to talk shop about your interests, concerns, and goals. To find out more, call us at (561) 422-4116; click here to contact us; or follow us on Facebook, Instagram, Twitter, and LinkedIn. Your question could be answered personally by Dr. Pane himself in an upcoming Ask Dr. Pane segment, helping us educate and inform others while giving you the factual information you need to make the best choices for your own care. Remember, at ACA we believe the only bad question is the one you DON’T ask!