Aesthetic Breast Surgery,Breast Implant Revision & Fat Transfer

Fat Transfer to the Breast

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COSTS:
Plastic surgeon’s fee: from $10,180.

Applicable only to cosmetic breast enlargement by fat transfer. Cost varies depending on positioning and number of areas requiring liposuction for fat harvest.

2nd round fat transfer may be applicable for certain patients who wish to achieve greater size increases.

Total approximate cost for cosmetic fat transfer to the breast (uninsured patient, day surgery only, including hospital and anaesthetic costs): from $16,300

Associated item number:  45534 and 45535 - not applicable for any cosmetic patient; item numbers are only applicable for cancer reconstruction and patients with developmental breast differences. Reconstructive fat transfer requires individual quotes.

For costs of fat transfer performed in conjunction with the below operations, please see the respective pages.

May be performed with: BREAST IMPLANT REMOVAL
May be performed with: MASTOPEXY
May be performed with: TUBEROUS BREAST CORRECTION

LENGTH OF PROCEDURE/HOSPITAL STAY:
2-2.5 hours (as a stand-alone procedure)

Will add 1.5hrs to the duration of an operation when combined with other procedures (eg. Mastopexy, Breast implant removal)

Day surgery

Key Features of Fat Transfer surgery

Liposuction for fat harvest – Fat can be removed from different areas of the body (most commonly the thighs, abdomen and flanks/’lovehandles’) using careful liposuction. This involves sucking the fat through a metal tube that is inserted through a tiny cut about 3-4mm long. The fat must be handled very gently to prevent damage to the cells. The fat is then washed and filtered before being re-injected into the breast as a purified form of fat. For some patients, the liposuction offers the benefits of improving contours or removing stubborn fat deposits that don’t change with weight loss or exercise. The key risk associated with liposuction is the creation of contour irregularities or dimpling at the site of fat removal.

No breast incisions – The fat injections into the breast are made through needle holes. These holes don’t require stitches, so there are essentially no scars on the breast, when the breast is enlarged by fat transfer alone.

Soft, totally natural volume – Unlike silicone breast implants, breast augmentation by fat transfer is totally natural. When done carefully, using proper technique, the majority of the injected fat will survive as living tissue. The breast will look, feel and move just like your own natural breast. Perhaps most importantly, after breast augmentation by fat transfer there will not be any requirement for additional surgery, unlike breast implants which only have a limited lifespan and will always require correction or removal at some stage in the future.

Please note:

Fat transfer to the breast is an excellent procedure to achieve natural breast enlargement, but it is not a perfect technique, and in some cases the results may not be totally predictable. Whilst most women will retain around 75% of the injected fat by volume, other women may only retain 50% (or even less) for reasons that are poorly understood. We generally believe that the success of fat transfer is very technique dependent - with proper technique, the fat graft survival should be high.

Dr Campbell-Lloyd uses a very specific technique of low pressure aspiration, gentle washing and filtration with the Puregraft system. Techniques involving aggressive or high pressure liposuction are considered dangerous for fat harvesting and will lead to poor fat grafting outcomes.

Please take the time to read the following article in which Dr Campbell-Lloyd outlines the ways in which fat transfer varies compared to breast implants.

Reasons To Consider Fat Transfer to the Breast

Ladies wanting a modest breast enlargement: Breast augmentation by fat transfer is able to enlarge the breast by approximately 1 cup size in a single session, although carefully selected patients may experience greater enlargement. This is dependent on a number of factors, and Dr Campbell-Lloyd will be able to advise you what your expectations should be. Some patients choose to have a second round of fat grafting performed, in which case the total gains may be far more significant.

Not comfortable with the idea of breast implants: An increasing number of ladies feel uncomfortable with the idea of silicone breast implants. There are a few reasons for this, including the issues of “breast implant illness” and ALCL (anaplastic large cell lymphoma). Perhaps most importantly, breast implants have a limited lifespan and must always be replaced or removed at some point in the future. In other words, breast implants create the ongoing requirement for additional surgery for as long as a patient chooses to have breast implants.

Preference for “natural” appearance and feel: Cosmetic trends come and go. Fortunately, it seems popular once again to aspire to a ‘natural’ breast shape. The natural breast tends toward being fuller in the lower part of the breast without any unnatural ‘side-boob’, or the upper-pole fullness that only comes from breast implants. Fat transfer will always create a more natural appearing breast with a pleasing lower pole curve.

Remember, fullness at the top of the breast and prominent cleavage are both a result of the bra you choose to wear. Even with breast implants, most patients will need a bra to create the aesthetic results they desire. That’s why so many surgeons on Instagram only show photos of their post-operative patients wearing bras and bikinis!

Happy with existing breast shape: Fat transfer will not substantially change the shape of the breast. For patients who are happy with their breast shape, but who want additional volume, fat transfer may be the ideal technique.

Wanting to add volume to the breast at the time of breast implant removal or breast lift procedures: Fat transfer is very commonly performed in conjunction with other procedures to add volume. The most common procedures are:

  • breast implant removal / explant surgery (fat transfer may compensate for the volume lost with implant removal) and
  • mastopexy / breast lift surgery (fat transfer can add volume to the entire breast and enhance the upper pole and cleavage when performed with mastopexy).

 

Reasons this procedure may not be right for you:

Wanting a significant breast enlargement (greater than 1 cup size) in a single operation: Significant or disproportionate breast enlargement cannot be achieved in a single operation using fat transfer alone.

Not happy with breast shape: Fat transfer cannot substantially change the breast shape.

  • If the breast is stretched, or drooping (ptotic), then we recommend a mastopexy/breast lift procedure combined with fat transfer for additional volume.
  • If there is substantial asymmetry, we would recommend a mastopexy to allow for the shape of the right and left breasts to be properly matched. Fat transfer can be used to allow for volume matching, once the shape has been corrected.
  • If the breast is tuberous or constricted (click for details), then a mastopexy or breast implants may be needed to force the breast into a new shape. This can be combined with fat transfer to soften the appearance of the breast and give the most natural result.
  • If the crease under the breast is "amorphous" or not well defined, then the crease may have to be formed with an "internal bra" prior to having fat transfer. Lack of crease stability will result in a lack of control of the transferred fat volume.

Wanting significant “upper pole” fullness without a bra (ie. wanting a ‘fake’ look): Whilst we would generally recommend against chasing this appearance, if patients desire a very full upper pole of the breast, we recommend seeing a surgeon who is happy to insert a silicone breast implant to achieve this appearance.

Extremely lean women: Ladies who have minimal subcutaneous fat (most commonly competitive athletes and women with substantial muscle mass including body builders) may not achieve significant fat harvest volumes. This requires personal assessment. This is quite distinct from women with low BMI. Slim ladies with a BMI around 18-20 can still be excellent candidates for fat transfer. We never recommend that patients try to "gain weight" to facilitate fat transfer - this is futile and totally unnecessary.

Patients who have experienced "massive weight loss" with substantial "deflation": Fat transfer appears to offer less predictability in women who have had bariatric surgery and who have lost very large amounts of weight due to forced caloric restriction. Observational data suggests a higher rate of "rupture" of harvested adipose cells and less controllable outcomes.

What To Expect after Fat Transfer to the Breast

Bruising and swelling will be present both at the “harvest sites” (where the liposuction was performed) and at the injection site (the breast). This bruising will very often take on a yellowish colour quite quickly in the breast, and will be associated with a feeling of firmness in the first week or two. The breast will soften quickly, but the bruising discoloration may persist for up to 6 weeks in some patients.

Volume will tend to settle lower into the breast rather than creating substantial upper pole fullness.

The breast will maintain natural feel and movement. Silicone breast implants always result in the breast being firm,and immobile. Over time, breast implants will often become harder due to capsular contracture. Fat transfer allows the breast to maintain normal bounce and movement, as the tissue is soft and pliable. The breast will not harden, and there is no scar tissue capsule that develops around the injected fat.

The volume gained is permanent. Once the fat injected has stabilised (around 6-8 weeks), the breast enlargement achieved by fat transfer is a permanent change. If you gain or lose weight, the breast will gain or lose weight accordingly. However, the fat will never just disappear.

It is important to understand however that not 100% of the injected fat will survive in the breast. Current estimates suggest that with good technique, approximately 75% of the injected fat survives. This is variable, and there are a range of factors which may influence the rate of survival, including patient age, prior weight fluctuation, and previous treatments.

There will be swelling after fat transfer surgery which can make the breast appear larger than it will remain after full healing. This should not be confused with the fat being "reabsorbed". The permanent enlargement of the breast can ONLY be appreciated after 6 weeks when the swelling will have subsided.

There may also be swelling at the liposuction sites and this may take up to 4 months to resolve.

The most significant complication associated with fat transfer to the breasts is the issue of contour deformity after liposuction. Whilst this is an issue that can be avoided with careful technique in most patients, subtle dips and dimples may be apparent after liposuction even with extreme care.

Whilst there are no large incisions required for fat transfer, the small holes through which the liposuction is performed are routinely closed with a single dissolving suture, under the skin. A layer of glue is then applied to any incisions.

After fat transfer, patients are discharged home with a surgical compression garment (which provides compression from calves to under the bust) which must be worn at all times for the first 4-6 weeks. This garment is firm and is essential during recovery. There will be a soft but supportive bra also which should be worn as directed.

Patients are discharged with antibiotic tablets, and pain-relief medications.

Patients are discharged home with detailed instructions. The instructions include emergency contact details for Dr Campbell-Lloyd.

Routine follow-up appointments are made for:

  • 1-2 days post op
  • 10-14 days post-op
  • 6 weeks post op
  • and 3-4 months post op.

There will be some pain. Most patients will experience a sensation like a deep bruise where liposuction has been performed. Some patients will experience "nerve pains" after liposuction whcih can feel like a tingling or numb sensation.

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