WHAT IS FAT GRAFTING?

Fat grafting, or fat transfer, is a procedure used to remove fat from one area of the body and place it in another area to increase volume, change contour, fill in a defect or depression, or restore shape. Fat grafting can be performed in the breast to adjust volume and to improve contour in patients that have undergone breast implant removal, breast reconstruction, lumpectomy, breast radiation, or breast trauma.

Things to Considerations

Each woman considering fat grafting should have a thorough consultation and take time to consider the pros and cons of the procedure. Social media and the internet often portray this operation and an easy way to increase the breast size without describing the limitations in predicting long term results. For safest predictable results and best use of your time and resources, careful consideration should be given to you desires and long term goals.

Women who desire significant breast size increase should carefully consider options before choosing fat grafting. The most predictable techniques for long term outcomes in fat grafting to increase multiple cup sizes involve some “pre-expansion” techniques that usually involve wearing a device to prepare your breast for fat transfer. Without this approach, most of the fat injected typically does not survive, and women report usually less than 50% of the starting volume remains. For augmentation, grafting is time-consuming, expensive, and you should expect to need several sessions to achieve a long-lasting result.

Fat grafting can work well in modest volumes to correct irregularities, fill in volume gaps, improve contour and shape. The longevity depends on the amount of fat that survives the transfer, and is subject to your aging, weight changes, hormones, and genetics.

The Fat Grafting Procedure

Fat is harvested using a small cannula under low pressure with a syringe type device. This is not the same as liposuction and uses a more gentle and precise technique. The effect of using a more delicate technique of harvesting is to protect the integrity of the cells for transfer. The fat is then placed in a centrifuge filter, or alternate device to separate unwanted fluid and cells from the fat to be used in grafting.

Donor sites (where the fat comes from on your body) often include the abdomen, hips, and thighs. Donor sites that have the best fat tend to be areas that you might say are more resistant to change with weight changes. These cells tend to be more stable after transfer. The incisions can be placed in inconspicuous areas below the underwear line, in the buttock crease. The fat can be harvested often successfully even in thin women. Gaining weight before surgery is not necessary or recommended.

The area in need of fat grafting is carefully defined before surgery. The more stable and healthy the area is where the fat is being transferred, the greater the chance of fat survival and long term stability. The fat is transferred in very small amounts (1cc) at a time and the fat is gently layered into place to allow for greatest opportunity for adjacent blood flow which allows the fat to rapidly survive.

Post Surgery Expectations & Results

  1. You will wake up with a small dressing over the treated area and a surgical bra.
  2. Mild swelling and some discomfort are normal and to be expected. This resolves on its own and often requires some pain medication for 24 hours then only acetaminophen.
  3. You will be seen in the office 24 hours post-surgery and given a more comfortable bra.
  4. Swelling generally is mild and resolves in 2-3 weeks.
  5. Sutures are absorbable and do not need to be removed.
  6. You will have a compression garment on the fat donor areas site that is treated like liposuction surgery.
  7. Most patients who have surgery on Thursday can return to desk work Monday.
  8. Avoid strenuous activity for 3 weeks. Dr. Rudderman will tell you when you can start to exercise again.
  9. Measurable results are typically visible immediately, but be patient, healing and stabilizing takes time. It can take months for the “new you” to be clearly seen.

The results from the fat grafting procedure are long-lasting.  A good follow-up plan is necessary.  Additional fat transfer surgery may be considered if additional volume correction is desired. All breast need good long term follow-up for evaluation of breast disease by your practitioner of choice.

Fat Grafting FAQs

Does fat grafting and transfers work?

Fat grafting is most successful if the quality of the fat harvest is good, if the technique of harvesting and injection is gentle, and if the site to be grafted has good blood supply. Fat transfer volumes remain the most consistent long term when fat achieves a good supply and remains alive. Not all fat transferred will remain and fat that does not survive in small amounts may be absorbed. If too much fat is injected at a single procedure for the blood supply of the area, fat necrosis (cell death) can occur. This can often result in hard lumps and may need additional treatment for removal and re-grafting.

Who is an ideal candidate?

Patients that are generally healthy, non-smokers, with stable weight, and no active infections are best for fat grafting surgery.

How long will it last?

Generally the volume of fat transfer will stabilize at 3 to 6 months. Gradual volume loss can occur in some patients and volumes are subject to change with general weight gain, weight loss, aging, and other factors. The more volume injected at one time, the less predictable fat cell survival will be.

How many treatments are needed?

It is very common to need two, three or more treatments when fat grafting is done to restore volume, repair defects, or for reconstruction. The larger the defect, the more likely the need for additional fat transfer treatments. The first treatment often allows the site to become more vascular and often allows for significantly more volume to be placed at the second injection, particularly when this is done for a surgical revision operation. Additional injections of fat may be performed in 4-6 months depending on the tissue characteristics.

Can I have liposuction the same day?

Liposuction is designed to optimally remove fat from an area like the abdomen, or from a bilateral area like the lateral thighs or hips. Completing an area of liposuction at the time of fat grafting will depend on the amount of fat needed at the time of surgery, and possibility of need of more fat in the future and can be discussed during your consultation.

How can I improve the success rate?

Patients should carefully follow instructions regarding restriction of activities including exercise following surgery, avoid tobacco exposure, and maintain weight and a nutritional diet during the healing process.

Contact us at 678.566.7200 to meet with Dr. Rudderman in our Alpharetta or Midtown Atlanta offices.


Written and reviewed by:

This article was written by Dr. Randy Rudderman, who is board certified by the American Board of Plastic and Reconstructive Surgery (1994). He practices medicine at his offices in Alpharetta and Atlanta.
Learn more about Dr. Rudderman, his medical training, and credentials.

  • Dr. Rudderman and his staff made the experience easy and comfortable. They were realistic communicating surgery expectations, expected pain levels and down time from work. Nurses were informative and friendly and wait times minimal. I also liked the fact that Dr. Rudderman does all his own work and doesn't let other less experienced people do parts of the surgery the way other doctors may. I'm only one week out of the surgery, but I am very satisfied with the results so far.

    Susan Parker | Atlanta, GA

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Dr. Rudderman’s unique, integrated approach to plastic surgery employs only safe, effective, predictable surgical techniques that are driven by uncompromising respect for the natural condition of the human form. He understands that the body changes with time – as do desires. His primary goal is to deliver the best possible plastic surgery … specifically matched to each patient…in a safe environment with ultimate respect for every single individual…their concerns and goals. LEARN MORE »

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