Fat is having a moment—both as a viable alternative to filler and as a way to re-shape and re-volumize parts of the body that have lost their vitality due to age or weight loss. While using fat as a means to resize breasts is not exactly a new concept, how we understand its use and value in aesthetics is. To help understand it better, we spoke with plastic surgeons to get their take on fat’s use in breast augmentation.
How is fat used in breast augmentations?
There are really only two ways to add volume to the breasts—one is an implant, the other is fat. “Autologous fat grafting or fat transfer uses a patient’s own body fat to enhance the breasts without reliance on synthetic implants,” explains Miami plastic surgeon Sean Simon, MD. Fat is harvested via gentle liposuction from a donor area on the body, such as the abdomen, flanks or thighs and is then “processed in a way to purify the fat by separating it from the remainder of the fluid aspirate and condensed down to viable fat cells before it is injected into the breast tissues to enhance the volume or aid in reconstruction of deficits or to correct any asymmetry," he explains further.
Is fat transfer to the breast permanent?
Yes, but only to a degree. Once transferred fat cells are integrated and established in their new environment and have a new blood supply, they become part of the permanent breast tissue—which is when results can be unpredictable. “As far as how much fat survives the grafting process or the ‘take rate’, it’s usually considered to be approximately 60 to 70 percent whereas the remaining 30 to 40 percent of fat cells that do not survive the process are broken down, and absorbed via the body’s lymphatic system over a three to six month period,” explains Dr. Simon.
Fat will sometimes not survive because of poor blood supply, meaning that if there is a large, dense area of injected fat, it may not allow new blood vessels to reach the inner portion; then necrosis, or death of the fat cells, may occur. Also, Dr. Simon points out that transferred fat cells behave in the same manner as normal fat cells—they too can enlarge or shrink with weight fluctuations.
Surgical aftercare, such as wearing proper post-surgical attire, is important to get optimal results. Avoid sleeping on the area and the use of nicotine as it can be harmful to the process of fat cell survival and integration.