Explained: Breast augmentation with fat transfer

There are two main types of breast augmentation available; breast implants and fat transfer. While fat transfer has many benefits, it also has limitations depending on the preferences of the patient, so it may be unclear whether it’s right for you.

Here to detail the procedure in-depth and explain the difference between implants and fat transfer, among other interesting points, is internationally-renowned cosmetic surgeon Mr Foued Hamza.  

What are the key differences between a fat transfer and an implant?

There is a huge difference. Augmentation with implant is mostly used for the patient that wants a size bigger than two or three cups. With a fat transfer, it's more suitable for the patient that we do a combined procedure, mostly if we do liposuction and we use that fat to add it to the breast.

The second feature with the fat transfer to the breast is that we cannot have an augmentation bigger than one cup, one cup and a half. We have all of the reabsorption of the fat we’ve injected so after one session, we can't expect more than one or one and a half cup, which isn't the case with implants. If the patient's main interest is to get the augmentation with a size that is maybe two cups, it's better to have implants.

How is the fat removed?

The fat is removed via liposuction, which is a technique that doesn't destroy the fat we remove. So, soft liposuction, for me, is the best, with a thin canula that's maybe between 3 and 4 diameters. This fat is prepared and decanted, then centrifugated and washed. We prefer not to use this procedure with the local anaesthetic because the local anaesthetic may destroy the fat.

So, we suggest to do this procedure under a general anaesthetic because if we do it under local anaesthetic, it's impossible to get the fat removed without any anaesthesia. Mostly, we treat two procedures at the same time, so that really moves the fat by doing the liposuction and adding the fat. So, we have two procedures in one.

When can I return to normal activity after the enlargement?

The recovery for this procedure is like liposuction. Depending on how much area that we treat, it ranges between four days to one week. The patient needs to wear a garment for the liposuction and support bra for the breast. Just after the procedure there will be some swelling and then the result becomes stable within the next month.

Are results permanent? Can they be affected by ageing, weight loss or gain?

We prefer to do these cases with stable weight because if the patient is always losing and gaining weight, it maybe isn't the solution for this patient because we won't have the right size.

We advise the patient to get to a stable weight before doing this procedure and we give them all the information about this procedure, so they know everything about it. Mostly about the results because as we said, it's not suitable for the patient that they want two or three cup sizes because we can't reach that with one session.

We need to tell them that, if they aren't happy with the results, which will be stable after six to eight months, they can do another session. They have to have really reasonable expectations for this procedure.

What qualities should I look for in a plastic surgeon? What should be discussed beforehand?

It's important to choose your plastic surgeon, so it's kind of confidence between the patient and the surgeon. The patient needs to feel comfortable with the surgeon to go ahead with the procedure because as we say, the plastic surgery procedure isn't just on the day, it's the before and after.

I prefer to see my patients at least two times before the surgery to explain the procedure to them and to ensure that they understand everything we've told them. Then we do the surgery and we also have the follow ups, which are very important because we need to keep in touch with the patient. For many this is the first time so there will be some swelling, changes in sizes and bruising, so if the medical professionals treating them aren't available to answer questions, this may be frustrating for the patient.

It can be related to some kind of problems which could be avoided, and the patient may go to see another doctor and there will be a resulting issue. We really need to have very close confidence between the two.

If you’re considering breast augmentation with fat transfer, arrange a consultation with Mr Hamza to discuss your options via his Top Doctors profile.