Fat Transfer to Breast

Fat transfer to the breast is a specialised surgical treatment to restore volume and enhance breast contours, create a softer fuller cleavage, or to correct asymmetric and constricted breasts. Transplantation of patient's own fat cells can be used either as a stand-alone procedure or in combination with anatomical breast implants to further improve the aesthetic outcome of a breast augmentation.

Autologous fat transfer is one of the most versatile and effective treatments available for women seeking natural-looking aesthetic breast enhancement. It is used to refine and optimise breast appearance and correct a wide range of volume, shape and contour deformities.  

The breast consists of glandular and fatty tissue. The glandular tissue is located in the central portion of the breast and is surrounded by a superficial layer of fat. The ratio between these tissues varies among individuals and will change throughout life. Body weight, pregnancies, breastfeeding and menopause will further influence the shape and composition of the breast.

As fat transfer is performed to the non-glandular soft-tissue areas of the breast, it is ideal for treating the subcutaneous outline and contours, but less suitable for adding central volume and projection. A woman's individual breast size and shape will determine where and how many fat cells can be transferred in one procedure. There are several treatment options available, with or without breast implants, allowing for a fully customised breast enhancement.

At the Sorensen Clinic we provide specialised fat transfer treatments for the breast, chest and décolletage.

Fat transfer to the breast - treatment areas

Adipose tissue (fat cells) are harvested from areas of the body with excess fat, including: lower abdomen, waistline, flanks and inner/outer thighs. The donor site is selected so that the harvested tissue matches the requirements at the recipient site (the area treated). Mid-sized particles of fat cells are generally suitable for the breast and cleavage (structural fat grafting), while fine liquified particles are preferable for the thinner tissues of the chest and décolletage (micro fat grafting). 



The fat cells (adipocytes) are gently distributed in multiple layers. Subcutaneous treatment areas include: (1) the cleavage and chest-bone, (2) the upper portion of the breast, extending towards the décolletage, (3) the outer curve of the breast, (4) the lower curve of the breast. Treatment can be performed in each of these selected areas as required, or in all four zones simultaneously. Fat transfer will make the treated soft-tissue thicker and fuller, providing rejuvenated and healthy breast contours.



Transplantation of fat cells is also possible (5) in the space below the glandular tissue and above the pectoralis major muscle (pre-pectoral fat transfer). Treatment in this anatomical location will address the foundation of the breast. Pre-pectoral fat transfer is of particular benefit for women with a boney or angulated chest (convex or concave chest shape), to subtly re-orientate breasts that turn outwards, or for treating breast base asymmetries.

Fat transfer and anatomical breast implants

The combination of fat transfer and anatomical breast implants (also known as 'composite breast augmentation'), provides synergistic benefits beyond what can be achieved by either procedure alone. Breast implants will provide shape, core volume and projection, while the transplanted fat will improve contours, softness and the overall feel of the breast. 



Composite breast augmentation is of particular benefit for thin women, where fat transfer will increase the subcutaneous soft-tissue layer and make the breast implants less noticeable. The procedure will also reduce the risk of implant rippling or skin stretching. 



By improving the thickness of the soft-tissue covering the implant, there is also less need to position a breast implant below the pectoral muscle. By keeping implants above the muscle, breast movements will appear natural and unrestricted. The result is a natural-looking breast, requiring a smaller breast implant to achieve the desired outcome.



Treatments to selected parts of the soft-tissue envelope can also improve breast shape beyond the width, height and projection of the anatomical breast implant. When a 'high profile' breast implant is indicated (for optimal projection) in a thin woman, fat transfer will allow the surrounding soft tissue to gently taper over the boarders of the implant.



Moderate breast asymmetries can be addressed in a straight-forward manner (without using different sized implants). Women with a prominent rib cage or a bony upper chest will get better positioned breast implants closer to the midline.

Optimising cleavage shape and contour

Subcutaneous fat transfer along the inner breast curve ('parasternal fat grafting') is effective in providing a fuller cleavage and narrowing the inter-mammary distance. The treatment can significantly improve overall breast contours and is of particular benefit to slim women with limited soft tissue cover on top or along their breastbone.


The procedure is indicated when addressing the following conditions: (a) soft-tissue deficiencies in the cleavage, (b) a wide breastbone, (c) naturally separated breasts, (d) deformities in the lower breast quadrant (i.e. tubular breasts), (e) an uneven or bony thoracic wall.

Women with breast implants

Women with existing implants can occasionally benefit from fat grafting treatments (even years after the original surgery). For example a slim woman with well-positioned breast implants, who has experienced a degree of hormonal or age-related tissue atrophy around the implants and wishes to further optimise her outcome.

Exchange or removal of breast implants

Subcutaneous and pre-pectoral (deep) fat transfer will also provide aesthetic and structural benefits when exchanging or removing breast implants.

For women who wish to have their implants completely removed, the transplanted fat cells offer the possibility to maintain a degree of volume (i.e. preserving approximately 20-25% volume of a small or medium sized implant). If further volume is desired, a secondary fat grafting procedure can be performed after 3-6 months.

In addition to volume replenishment, fat transfer will provide physiological benefits to the treated tissue layers. This results in an overall improvement in tissue elasticity and redraping, with less tendency for developing skin laxity. This is an important advantage, both when removing implants, or changing to a smaller implant size.

Limitations

It is not possible to predict how many of the transplanted fat cells will survive and integrate into the treated areas. A typical volume retention will be around 30-50%. Individual variation is evident, relating to body weight, age, anatomy, metabolism, endocrine and hormonal status, as well as general health.

There is also an upper limit as to how many fat cells can be transferred in one procedure in order to facilitate cell viability. This limit is not well-defined and will vary between individuals. For this reason a conservative approach is always preferable. The optimal fat transfer in an average sized breast is usually not more than 100-120 ml. Two treatments are generally better than one, for women who require increased volume.

Fat transfer vs. breast implants

Fat grafting (as a stand-alone treatment) should not be regarded as an alternative to the use of breast implants. It will require 4-5 treatments to gain the same volume, as can be achieved with one breast implant surgery. Although fat transplantation is superior when it comes to breast contour enhancement, it will not provide the projection of an anatomical implant.
 
For this reason fat transfer is not usually the primary recommendation for a young woman who seeks to improve on her breast shape and projection. This will be better achieved with an anatomical breast implant. However, for those women who wish to avoid implants, fat transfer offers the best option to improve on existing volume and contours.

Individualised breast enhancement

Autologous fat transfer is one of the most valuable treatments, to restore healthy breast contours, achieve a fuller cleavage, balance asymmetries or to shape uneven breasts.

Transplantation of fat cells in combination with anatomical breast implants can be considered a step beyond conventional breast augmentation, providing even further possibilities for aesthetic refinement. During consultation, Dr Sorensen will examine the breast, measure proportions and discuss individual goals, in order to formulate an effective treatment plan, with or without implants.