Fat transfer breast augmentation (breast augmentation with fat injection)

Information on breast augmentation with fat transfer

Breast augmentation can be achieved through fat injection into the breast (fat grafting to the breasts). This method, which does not involve implants, is increasingly popular. It offers a very natural and long-lasting result. However, sufficient fat reserves are required to achieve the desired volume.

During your consultation with your cosmetic surgeon, they will assess whether this technique is suitable for you.

The results of this type of breast augmentation are very natural and stable over time. Once the desired volume is achieved, as long as there are no significant weight changes, there is no need for reoperation; the injected fat volume remains permanent.

Learn more about breast reconstruction using fat transfer.

When can you undergo breast augmentation with fat transfer?

Fat transfer breast augmentation has revolutionized aesthetic surgery results, though this technique was previously banned in France. In 2014, the French National Authority for Health convened a national committee of experts, including Dr. Benjamin Sarfati, to establish best practice guidelines for fat transfer to the breast (lipofilling). National recommendations were published in January 2015 (click here), allowing breast augmentation via fat injection under specific guidelines:

“In the context of aesthetic and reconstructive surgery without a history of breast cancer (e.g., congenital malformations), contraindications to autologous fat grafting to the breast include:

• Unrealistic patient expectations regarding results (such as the desire for a significant increase in breast size);
• Insufficient fat reserves;
• Weight instability (e.g., bulimia or anorexia);
• Family risk factors (similar to those considered during oncogenetic consultations), histological factors (biopsy showing atypical lesions), genetic predispositions (e.g., BRCA1 and 2, PTEN, P53), and medical conditions (e.g., thoracic irradiation);
• An active breast cancer pathology, indicated by an abnormal preoperative radiological assessment (ACR 3, 4, 5, or 6).”

Breast augmentation via fat transfer (without implants) is performed by injecting the patient’s own fat. This fat is harvested from areas with excess fat deposits through liposuction. The collected fat is then decanted and purified before being reinjected into the breasts. The scars from this cosmetic procedure are minimal, typically measuring only a few millimeters. The purified fat is injected using fine cannulas, leaving no visible scars on the breasts. Thus, during the same procedure, the patient benefits from both breast augmentation without implants and liposuction.

Learn more about breast reconstruction with fat transfer.

Fat transfer breast augmentation (lipofilling for the breasts) offers several advantages. It provides a more natural feel and appearance compared to implants, eliminates the risk of rejection since it uses autologous tissue, and avoids potential complications associated with implants, such as ruptures or capsular contracture. Additionally, the procedure allows for the contouring of another area of the body from which the fat is harvested, resulting in a dual aesthetic benefit.

However, there are also some drawbacks. A portion of the injected fat may be reabsorbed by the body, potentially requiring multiple procedures to achieve the desired volume. The amount of fat that can be harvested and reinjected is limited, making it challenging to achieve significant increases in breast size. Lastly, like any surgical procedure, there are minimal risks of infection or irregularities in shape, especially if not performed by an expert in breast surgery.

Fat transfer breast augmentation is suitable for women looking to moderately increase their breast size (up to one cup size) or make minor corrections, provided they have sufficient fat reserves for harvesting. This technique is particularly beneficial for women with an imbalance between their chest and hips, such as having small breasts and rounder hips. In these cases, fat transfer can achieve remarkable results.

Additionally, fat grafting to the breasts can be part of a reconstructive strategy following breast cancer and subsequent mastectomy.

Before considering breast surgery, several consultations with the surgeon will be scheduled.

Initially, patients meet with Dr. Sarfati to discuss their expectations and ensure there are no contraindications to the procedure. In a subsequent appointment, Dr. Sarfati conducts a clinical examination to verify that there is sufficient fatty tissue available for harvesting and that the initial breast shape is suitable for fat transfer breast augmentation (absence of breast ptosis).

Following the examination, Dr. Sarfati provides a detailed explanation of the procedure, discusses the post-operative care, and arranges a consultation with the anesthesiologist.

Additionally, prior to the surgery, patients will be required to undergo several tests, including a mammogram and blood work to check blood cell counts, hemoglobin levels, coagulation, kidney and liver function, serologies, and blood type.

On the day of the procedure, the patient arrives at the clinic in the morning and is discharged the same day (outpatient surgery). The fat grafting to the breasts procedure is performed under general anesthesia in the operating room. Prior to the surgery, a mammogram and breast ultrasound are required. A compression garment is applied to the areas where fat is harvested and should be worn for approximately two weeks.

The postoperative care following a breast fat transfer procedure is straightforward. There may be slight swelling at the fat donor sites, which typically subsides over the following weeks. Generally, a recovery period of 48 hours is recommended.

A compression garment should be worn over the donor areas for one month after the procedure. This helps to reduce swelling and minimize bruising. Postoperative discomfort is usually mild and can be effectively managed with standard pain relievers.

In the case of a breast fat transfer, the incisions made by the surgeon at the donor and injection sites are very small, typically around 3 mm. These incisions are used for the insertion of a micro-cannula to either aspirate or inject the fat. As a result, the scars left behind are almost invisible.

The cost of breast fat transfer can vary significantly based on several factors, including the complexity of the procedure and the type of postoperative care required. Typically, this fee covers the pre-operative consultation, anesthesia costs, the procedure itself, and post-operative follow-up.

It’s important to note that, in most cases, breast fat transfer is considered a cosmetic procedure and is not covered by health insurance. However, it is always advisable to discuss financing options with Dr. Sarfati in Paris to get a more accurate estimate and a personalized quote.

What are the benefits of breast fat transfer?

Breast fat transfer is a natural technique that uses the patient’s own fat, minimizing the risk of allergies or rejection. This procedure offers more natural-looking results compared to implants and enhances overall body contour by removing fat from unwanted areas.

When can you resume activities after breast fat transfer?

Breast fat transfer is a less invasive procedure compared to breast augmentation with implants, so recovery is generally quicker and less painful. Intensive physical activities should be avoided during the first week after the procedure, and you can typically return to work after one to two weeks, depending on the nature of your job.

How long do the results of breast fat transfer last?

One of the main benefits of fat transfer breast augmentation is the long-lasting results. Unlike implants, which may need replacement after several years, breast fat transfer can provide results that last a lifetime. Once the transplanted fat cells have established a blood supply and integrated into their new environment, they function like the body’s natural fat tissue. However, it’s important to note that significant weight fluctuations can affect the volume and shape of the breasts.

What are the differences between breast fat transfer and breast implants?

Unlike breast implants, breast fat transfer uses the patient’s own fat, providing a natural-looking result and avoiding the risks of allergies or rejection.

How much volume can I expect to gain with breast fat transfer?

The volume increase depends on the amount of fat available and transferred, which is usually moderate. To achieve a significant increase in cup size, breast implants are generally a better option.

What are the risks or side effects of breast fat transfer?

While breast fat transfer is generally considered safe, it can present risks if not performed by an experienced surgeon. These risks include irregularities, partial absorption of the fat, or infection. However, these risks are typically lower compared to those associated with breast implants.

Is there a link between breast cancer and breast fat transfer?

Breast fat transfer uses autologous fat cells, meaning they come from the patient’s own body. This technique provides lasting results and, in cases of previous breast cancer, can offer a permanent reconstruction option. It is essential to note that breast fat transfer does not increase the risk of developing cancer or experiencing a recurrence.

How is breast fat transfer covered by health insurance?

Breast fat transfer may be covered by health insurance if it is classified as reconstructive surgery. Coverage is typically automatic if the procedure follows a mastectomy or if it was performed as a preventive measure against breast cancer.

Is the result of breast fat transfer permanent?

Breast fat transfer yields long-term results. The final outcome is generally visible after about 3 months. However, the results may slightly decrease over time as some of the injected fat may be naturally absorbed by the body.