Fat graft breast augmentation is a procedure using fat from areas where fat is not desired, such as the abdomen, hips, outer thighs; less commonly, inner thighs, inner knee and arms and transferring the fat cells to the breast for a natural, autogenous (from yourself) breast augmentation effect. Fat grafting to the breast can be performed alone, to increase the upper pole and lower pole of the breast by 1/2 cup size to 3/4 of a cup size.
Fat grafting is commonly performed on individuals who want a modest increase in projection and size without a breast implant.
Fat Graft Breast Augmentation Procedure
During the consultation with Dr. Mulholland, a Toronto cosmetic surgeon, the advantages and disadvantages of fat transfer to breast will be discussed. The donor site for the fat is selected and then prepped and draped in a sterile fashion and local anesthesia is instilled into the region. Common donor sites include the hips, abdomen and outer thighs. Once the local anesthesia is instilled, a device called the Vaser is inserted to gently separate the fat cells with ultrasound energy.
Figure 1. The tip of the VASER probe emits gentle ultrasound waves that gently separates fat cells for easy removal BUT, does not destroy adipocyte fat cells, so they can be transplanted successfully to the breasts after Vaser Liposuction, also called Ultrasonic-assisted Liposuction.
Vaser Liposuction on fat cells
Vaser Liposuction is then performed on the donor site. The Vaser ultrasound energy is gentle and will keep the fat cells and stem cells alive for successful fat grafting breast augmentation. Once the fat cells have been loosened and separated, a suction device is used to remove the fat cells into a canister, where the fat cells can be collected and prepared for breast augmentation.
Following harvest, the fat graft material is prepared. Preparation generally includes centrifugation and separation of the fat cells and stem cells from unwanted blood products, serum and local anesthesia. Once the prepared fat cells and stem cells have been prepared, they are transferred in an a-traumatic fashion to small injection syringes.
Breast preparation for fat transfer
The breasts are then prepped and draped in a sterile fashion and a small, blunt-nose injection needle is used to expertly place the fat grafts in the aesthetic areas required for optimal contour shape and projection and form.
The injection technique with fat graft into the breast is extremely important and involves multiple small toothpick-shaped fat grafts layered throughout the deep tissues such as the pectoralis major and subcutaneous tissue in the breast gland. It is important that each fat graft be no more than one millimeter away from a blood supply; hence, very small toothpick-like structural fat graft is performed throughout the breast tissue and underlying muscle.
Figure 2. A small blunt tipped micro-cannula, millimeters in size, is used to insert the fat grafts during the fat grafting breast augmentation procedure. The gentle, blunt tipped micro-cannula is gently advanced forward through the breast tissue pushing the breast tissue away and leaving a potential tunnel of tissue around the micro-cannula. The micro-cannla is then withdrawn slowly and small “tooth picks” of fat grafts are slowly expelled from the syringe during the retrograde movement (pulling back movement). As soon as the fat grafts are deposited, the host tissue envelopes around them, stabilizing them and bringing in nutrients and a blood supply.
Can the fat grafts move around once the augmentation has been performed?
The fat grafts transplanted through injection into the breast tissue through natural fat graft breast augmentation cannot move, or become displaced. By placing the grafts with a cone of host tissue on retrograde withdrawal of the micro-cannula, the surrounding breast tissue collapses around the fat grafts, enveloping them and stabilizing their position, so that any physician forces, such as lying on the stomach, high impact aerobic activity or intimacy, will not harm, disrupt or shift any of the fat cells in the least.
Figure 3. The fat cells are shown in yellow and are deposited gently in the breast tissue, using the blunt micro-cannula and a retrograde (pulling back) technique. The graft tissue is expelled in tiny micro droplets, creating I structural columns through the breast tissue to be augmented. The host tissue collapses around the grafts providing 360 degree stabilization and fixation, so that the fat grafts cannot be disrupted or displaced. This delicate and methodical technique ensure a high percentage of fat graft transplant survival for Toronto fat grafting to the breast patients.
Figure 4. A picture showing the small “tooth pick” sized columns of fat grafts (depicted in yellow) that are placed in the breast tissue in a retrograde fashion to optimize the stability as well as viability as each fat cell is within 1 mm of a blood supply
Who is a candidate for fat grafting to the breast and natural fat breast augmentation?
Good candidates for fat grafting to the breast include patients that want an increase in volume and proportion of segmental areas of the breast. Individuals who already have breast implants and have underlying visible irregularities or palpable irregularities such as rippling or sharp take off of the breast implant from the chest wall, will be good candidates for the procedure. Patients must have an adequate amount of fat in the donor sites, to enable the harvest of enough fat.
Candidates who have undergone a previous lumpectomy with a depression or one-sided irregularity or have one breast that is smaller than the other as a result of hereditary factors may also be suitable for the procedure.
Figure 5. The yellow cells inside the syringes are purified fat cells and stem cells that were removed from the patient’s tummy and hips. The fat grafts were then prepared by centrifugation and separation of the unwanted segments and the purified fat graft and stem cells are placed in the syringes. Dr. Mulholland then uses a small blunt cannula to gently place the fat grafts and stem cells in the breast tissue where they will pick up a blood supply and then live, act and feel like normal breast tissue.
How much of the fat grafts to the breasts will survive?
Optimal survival of the fat grafts depends upon several variables. First, gentle harvest and handling of the Vaser Liposuction fat graft tissue is critical. The preparation of the fat grafts must include gentle handling, centrifugation and separation. Finally, the actual fat grafts themselves need to be inserted gently and expertly into the breast tissue.
Each fat and stem cell should be within 1 mm of a blood supply. The first 3-4 days the fat cells survive on passive diffusion of nutrients. The process of each fat cell getting a blood supply is called neovascularization and the process takes 72-96 hours and is dependent upon the experience of the surgeon and his placement technique.
Figure 6. A. Fat grafts have been placed in the breast tissue, in delicate rows or tooth picks. The fat grafts are stabilized in the host tissue so they don’t move and B. Have enough space between them to allow the growth of new blood vessels to proliferate around them over the first few days ensuring a blood supply and survival of the fat grafts to the breast and a long-term fat graft breast augmentation result.
What kind of anesthetic is used for fat grafting to the breast?
Most fat transfer to breast can be performed under simple local anesthesia and oral sedation. Local anesthetic is used in the donor site where the fat grafts are harvested and also into the breast site where fat grafting to the breast is performed. The most common donor sites used to harvest fat grafts for natural fat grafting breast augmentation include the hips, tummy and outer thighs.
For some patients, who are more anxious, or don’t want to be aware of the procedure being performed, general or IV anesthesia can be used for fat grafting to the breast.
Is fat transfer to breast and natural fat graft breast augmentation painful?
Once the local anesthetic is injected, fat grafting to the breast and natural fat graft breast augmentation is not a painful procedure. After the procedure, the discomfort feels more like a “bruise” and non-steroidal anti-inflammatories usually suffice to treat this discomfort.
Can I have liposuction at the same time as fat grafting to the breast and natural fat graft breast augmentation?
Yes it is very common for patients to request more fat be taken from the donor sites than is needed. It is important to note, however, that occasionally a second fat grafting procedure may be requested to the breasts 1-2 years after the first session. Preservation of some fat is necessary.
How long does the fat graft breast augmentation procedure take?
The fat grafting procedure to the breast takes approximately 1.5 hours. Usually one, two or three body zones are selected, depending upon the amount of fat in those zones and the harvest takes approximately 45 minutes to an hour. This will be extended if patients also want post-harvest liposuction contouring to be performed in the donor site. The fat grafting to the breast takes approximately half an hour and the average time for a fat grafting breast augmentation is 1.0 hours.
Figure 7.A. Before fat grafting to the breast. Fat was harvested from the abdomen and hips and 300 cc of prepared fat grafts were transplanted to each breast, for a total fat graft volume of 600cc. B. The results of the natural fat graft breast augmentation at 12 months showing a nice improvement in projection, volume and contour.
How long is the recovery following the operation?
Most patients following fat grafting to the breast can return to normal activities of daily living the following day. The breasts will be somewhat swollen and a little bit bruised and sore, but this is well-concealed in a soft sports bra. The swelling and bruising usually returns to normal within two to three weeks. The procedure is far less painful than artificial breast implant procedures performed under the muscle.
What kind of results can I expect from my fat grafting to the breast and natural fat graft breast augmentation?
Patients who undergo fat grafting to the breast can expect a very nice improvement in breast contour with a modest and pleasing increase of projection shape and contour. The result of fat grafting to the breast and Natural Fat Graft Breast Augmentation is excellent in properly selected patients who are looking to achieve a ½ to ¾ cup size improvement or augmentation to selected areas of the breast or implant or irregularity camouflage.
The results for primary augmentation are only modest in comparison to breast implant augmentation surgery using a cohesive gel or saline implant. Well-selected patients have fat grafting to the breast and natural fat graft breast augmentation specifically because they want to avoid saline or cohesive gel breast implants or want to improve the results overlying their saline or cohesive gel breast augmentation. In general, most patients can expect a half to three-quarter cup size improvement and a noticeable improvement in the upper pole or lower pole if localized fat grafting is performed.
Figure 8.A. Fat Graft to the Breast patient who presented with decreased breast volume in the upper poles. B. 1.5 liters of fat were removed through vaser liposuction from the abdomen and flanks achieving an excellent abdominal-hip-flank contour improvement. The vaser lipo fat was then prepared and purified and then 400 cc (800 cc total) was then injected and transplanted into each breast. B. The 12 month result show a nice, natural increase in volume and proportion, contour and projection of each breast following the natural fat graft breast augmentation.
What are patients saying about their fat grafting to the breast?
Patients who undergo fat grafting to the breast are generally well-selected and are very happy with the results of their natural fat graft breast augmentation procedure. Very unique and individualized contour shape, projection and form can be achieved with the use of fat grafting to the breast, with or without underlying breast implants and patients who have undergone this procedure with Dr. Mulholland are generally very happy with their results.
Figure 9.A. Toronto Fat Graft breast augmenation patient with a previous breast augment procedure using silcione gel implants that result in some volume asymmetry, a sharp take off of the chest wall-augment junction. B. Vaser lipo fat graft harvest and Vaser Ultrasound assisted Liposuction was performed removing 2.2 liters of fat from the abdomen and flanks resulting in a pleasing liposuction contour improvement. The Vaser lipo fat grafts were prepared and purified and then 400cc of prepared fat grafts and stem cells were injected and grafted into each breast (800 cc in total). The Toronto fat grafting to the breast patients was very happy with the results of her natural fat graft breast augmentation.
Figure 10. A. A Toronto Fat graft to the breast patient who presented following a previous lumpectomy surgery for a right sided breast tumor. The lumpectomy resulted in a loss of volume and contour depression in the lower quadrant of the right breast. B. The patient underwent a breast augmentation procedure using a cohesive silicon “gummy bear” breast implant on each side and then additional fat grafting to the right lower quadrant of the breast over top of the breast implant itself.
Is there any maintenance required following the fat grafting?
There is no specific maintenance required. Generally, 30% to 60% of all fat grafts will survive and Dr. Mulholland generally over-grafts, accounting for the fat grafts that will not take. Most patients are happy with their volume, shape, projection and form enhancement following a single procedure.
However, most patients are warned, prior to selecting fat grafting to the breast as a procedural option that a second session performed 12 months later may be required to optimize the breast volume and project and overall aesthetic improvement, and results.
How much will fat graft breast augmentation cost?
Fat grafting to the breast costs range depending upon the number of body areas that must be harvested and the amount of fat that is required for the fat-grafting breast augmentation result.
In general, fat grafting to the breast costs approximately the same as cohesive gel augmentation to the breast, with the advantage that you can have some body liposuction contouring done on the donor site at the same time as natural fat graft breast augmentation which you do not get using standard breast implant surgery.
Does fat grafting to the breasts limit radiologists’ ability to detect a breast cancer on mammograms, CT or MRI?
The American and Canadian Radiology Associations have gone on record as saying that fat grafting to the breast, breast reduction, breast lift or augmentation does not limit their ability to detect breast cancer cells from reactions around the fat grafts within the breast or other types of surgery.
Interesting Breast Augmentation Treatment Facts
Dr. Mulholland was one of the pioneers and leaders in developing the endoscopic armpit incisional approach to breast augmentation surgery. In 1997, Dr. Mulholland was one of the first plastic surgeons in Canada to introduce tear-dropped, anatomic shaped breast implantation. Saline implants, either round or tear-dropped and small gel implants, can be inserted through the armpit, leaving the breast mound without scars. Dr. Mulholland also helped pioneer the use of low level arconium laser systems to greatly minimize, if not eliminate, capsule formation. Learn more about breast augmentation here.
How can I show Dr. Mulholland my concerns and see if I am a candidate?
Toronto fat grafting to the breast patients should simply fill out the appointment request form or “ask a question” form and upload up to 3 photos for Dr. Mulholland to review.
How do I schedule a consult for fat transfer to breast and natural fat graft breast augmentation?
Schedule a breast augmentation consult with Dr. Mulholland today to start the process in achieving the ideal balance in figure. If you have any questions regarding your face and body treatment options, don’t hesitate to call us to schedule an appointment. Our SpaMedica Toronto office can be reached at 877-695-2835. Alternatively, you can book a consultation online.