Many patients, usually in a light hearted way, ask “Can’t you just take it from here and put it there?, normally referring to transfer of fat from the buttock or hip area to the breasts.
Conceptually it is an ideal solution to two common problems. Unfortunately, however it is not that simple.
The idea of grafting fat from one area of the body is not new. In earlier years the success rate of this procedure was suboptimal. Recently however newer techniques in fat harvesting, processing and injecting have made it much more successful.
Breast augmentation utilizing fat grafting has some potential advantages. Capsular contracture, a well-known potential application of breast augmentation utilizing breast implants, would be avoided. Concerns regarding implant leakage or deflation would be prevented.
Fat grafting to the breast has significant limitations however. It is a much longer procedure and the amount they can successfully transferred is limited. Sequentially the size that can be achieved with breast implants is not possible with fat grafting. In most reputable studies an average increase is not more than one cup size. When fat grafting is performed the fat is diffusely injected into the breast. Consequently the visual impact is not as dramatic as the localized increase achieved with breast implants.
Up until recently, grafting has been injected as a means of breast augmentation due to concerns about the detection of breast cancer. Any fat that does not survive can lead to areas of calcification which makes mammographic evaluation of the breast difficult. The potential for causing areas of calcification however exist for any type of operation which traumatizes breast tissue. With newer techniques in fat grafting, the likelihood of fat not surviving the transfer and causing calcifications has been lessened.
When considering a procedure such as this, it is very important to select a surgeon that is skilled in all methods of breast reconstruction. You should choose a surgeon who can listen to your concerns, understand your goals and select and perform the operation that is best for you.