PATIENT RESOURCES / DR’s Blog

The Many Myths About Fat Grafting

by | Breast Fat Transfer

There are many myths about fat grafting to the breast. I perform a lot of fat grafting procedures and I hear about them at my office all the time. So let’s go over some of myths now and try to clear them up:

1. MYTH: Fat will disappear.

FACT: The process of fat grafting requires harvest from another site, followed by processing, and finally injection. During the procedure some fat cells can be damaged. While the goal is to remove all liquid (injected to minimize pain and bleeding), blood, and non-viable fat cells, some will still be injected. On top of that, even some perfectly good fat cells will not obtain proper blood supply in the breast. So not all of the volume injected is actually healthy fat cells that get good blood supply. That which isn’t gets absorbed by your body, leaving you with the healthy fat that did survive. In addition, you will have swelling from the procedure that will take time to settle. The fat that you have at a couple of months though is likely to be permanent. If, however, your weight goes up or down, so too will the size of your breasts.

2. MYTH: Fat grafting is an easy surgery.

FACT: Fat grafting has many benefits over implants, but is a longer and more technically demanding procedure. Every step of the way needs to be done meticulously, or the fat survival rate will go down. It is time consuming and takes a lot of patience on your surgeon’s part. Not all surgeons have the patience to get the ideal result. If they are not willing to place the fat drop-by-drop, the result will be limited.

3. MYTH: Fat cannot increase the size of the breast very much.

FACT: Because of the importance of blood supply, you can essentially double the size of the breast at the time of surgery. If you over-exceed that amount, the fat will not have good blood supply, and may not survive as well. After resorption of fluid and cessation of swelling, you can expect a 50-60% larger breast than pre-surgery. If a second surgery is done, you can inject even more than the first time, leaving your final volume 2-2.5x larger than when you started if all goes well.

4. MYTH: Fat grafting and implants are never done together.

FACT: Fat grafting is an amazing technique to use in conjunction with an implant. Although many patients do not need this, it can conceal the edge of an implant really well in thinner patients. This provides patients with a full, yet still natural looking and feeling result. It is also great for enhancing cleavage in patients with wide set breasts. However, very few surgeons do this. It is only done by surgeons with a very specialized interest in both breast surgery and fat transfer. With all that being said, I have done it countless times and the results can be amazing.

5. MYTH: Fat will leave me with lumps or dents.

FACT: Fat grafting can provide amazing looking results that are natural looking and feeling. However, the process MUST be done very carefully. If too much fat is placed, or if it is done without precision, then you will have a much higher chance of fat loss or oil cysts. You must go to a surgeon that has a very specialized interest in fat transfer. Not all surgeons provide great results with fat transfer. It is not as straight forward as placing an implant.

7. MYTH: Fat transfer is better than implants.

FACT: There is no perfect surgery. I spend a lot of time over several visits with my patients helping them come to the best plan for them. Fat transfer is great, as there are virtually no scars, you get to treat a "problem" area with liposuction, and the results are very natural. However, it does not do as well to increase volume when you desire a much larger breast. It also does not enhance the shape of the breast as well as an implant in someone with a less pretty shape to begin with. Your surgeon should go over the pros and cons of all your choices and help you decide which is the best for you.

8. MYTH: Fat grafting can be done in anyone.

FACT: Although fat grafting can be done in anyone, not everyone is an ideal candidate. You need to have enough fat to harvest to make it worthwhile. Sometimes the only fat people have is in the buttocks. Not all patients want to give up volume in their buttocks. You also need to have a place to put it. If you are so thin that there is little space to place the fat, you may need more than one surgery. Remember, you can double the size of the breast at the time of surgery, leaving you 50%-60% larger in the end. With a second surgery, you can put a fair bit more fat than the first, leaving you up to 2-2.5 times larger than when you started. For some patients, they may simply do better with an implant and some fat grafting to conceal it well.

9. MYTH: There is only one perfect technique.

FACT: Many surgeons that do a lot of fat grafting use very different techniques for how they harvest the fat and how they process it. So long as care is taken to minimize injury to fat, there are lots of ways of doing these steps. What virtually all surgeons agree on is that fat must be carefully placed and you must not exceed the maximum volume. You have to be a perfectionist to get the best possible result from breast fat transfer.

If you are interested in booking a consultation for breast fat transfer or breast implants, please contact Dr. Rodger Shortt to arrange an appointment at 905-849-4282 or info(at)drshortt.com.

Dr Rodger Shortt is a plastic surgeon servicing Toronto, Oakville, Mississauga, Burlington, Milton, Hamilton and Georgetown. He strives to provide his patients the best care and excellent plastic surgery results. He is one of only a few plastic surgeons in Canada with a top rating on RateMD, RealSelf and Ontario Doctor Review. Dr Rodger Shortt is a specialist plastic surgeon trained in cosmetic surgery and reconstructive surgery. He specializes in breast surgery, breast augmentation, breast fat transfer, mommy makeover, tummy tuck, body contouring, breast reconstruction and cosmetic surgery of the face. He is the Director of Cosmetic Surgery Training at McMaster University and an Assistant Clinical Professor.

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Fabulous Doctor, Extremely smart ( like Mensa IQ ) with attention to detail.

Fabulous Doctor, Extremely smart ( like Mensa IQ) with attention to detail. Confident, clear, and precise in conversations. Hand surgery was done extremely well with 4 breaks in one shattered bone. Bone was wrapped and pinned in titanium chain links and micro screwed. Recover has been excellent I have 100% of mobility in my hand and work in home renovation. The scar is small pin sized line, not noticeable; no extra bumps or blemishes. Truly a five star surgeon. I am hoping he does face surgery.

I was so pleased that my GP referred me to Dr Shortt

I was so pleased that my GP referred me to Dr Shortt, for knee surgery. Excellent caring Doctor, if you need plastic surgery place Dr. Shortt, at the top of your list. Great experience, great results, this Doc, is a 10!

I simply cannot find enough superlatives to express my gratitude

I simply cannot find enough superlatives to express my gratitude to Dr. Short for his wonderful work.
I have, for many years now, had numerous black moles and dark spots on my face and they seemed to be multiplying. Dr. Short removed over 40 of these and when I left his office, I have to admit, I was worried. I looked pretty rough. But there are no crevices or dips in my skin (of which I thought there’d be many) and most incredibly there is no visible scarring at all. It’s hard for me to say how much better I feel now. I have a refreshed, natural look. I am a career musician and in the public eye so, needless to say, I feel so much more confident about my appearance.
Dr. Short was honest with me from the beginning. He clearly explained options to me but never made me feel that he was up selling other services. I was fearful and had huge reservations about having anybody touch my face but everything about my experience with Dr. Short and his staff was positive and I would have absolutely no hesitation to recommend him. He has my sincere thanks.

You can tell the enthusiasm and passion Dr.Shortt has for his work

From the get go the professionalism and expertise I had received far surpassed those from other consultations I had done. I had gone in for a breast augmentation and am amazed from the results. You can tell the enthusiasm and passion Dr.Shortt has for his work. He had stated that afterwards my breast would look “perfect”, I figured anything would be better then what I had. Unbelieving then, here I am now absolutely thrilled with the results. I had a tattoo where the implant incision would be, to my surprise Dr. Shortt was able to work around it as well.

Breast Augmentation – What an Amazing Doctor !

From the get go the professionalism and expertise I had received far surpassed those from other consultations I had done. I had gone in for a breast augmentation and am amazed from the results. You can tell the enthusiasm and passion Dr.Shortt has for his work. He had stated that afterwards my breast would look “perfect”, I figured anything would be better then what I had. Unbelieving then, here I am now absolutely thrilled with the results.

I had a tattoo where the implant insission would be, to my surprise Dr. Shortt was able to work around it as well.

The day of my surgery Dr. Shortt and his team made me feel very comfortable and well taken care of. Thank you again !

Dr. Shortt has a great eye and is a creative visionary

Everyone reacts differently to a diagnosis / treatment of breast cancer. For me, after the mastectomy, I no longer felt whole. I decided reconstructive surgery was the answer which was very intense – but no regrets. The results were good but I still felt a little mismatched. My surgeon referred me to Dr. Shortt. Like so many others on this site, I felt like he knew exactly what I was looking for and how to get there. Dr. Shortt has a great eye and is a creative visionary that can determine what need to be done, coupled with the skill to do it. What really differentiates him from the rest though, is his empathy and understanding. You don’t often find doctors who are good at combining the science with compassion. This was a surprising and greatly appreciated aspect of my care. I am 4 weeks post op now and I have to say the results are spectacular. I feel like the sisters have been reunited and I am whole again. If you have had reconstructive surgery and feel you need a little more finessing, take my advice and make it happen. You will be glad you did. I would highly recommend Dr. Shortt to my closest friends and family and to anyone looking for cosmetic improvements.

Thank you again,

Susan

Amazing plastic surgeon

Amazing plastic surgeon who was initially referred to me by another plastic surgeon. From my first consultation, Dr Shortt immediately knew what surgical procedures were the best option for my situation. No hesitation in diagnosis and recommended plan of action. I’m a breast cancer survivor and I thought a breast reconstruction was a lost cause for me due to my extension radiation treatments and consequential skin damage. Dr Shortt was very methodical and professional throughout the entire 18 month process. Before each surgery, I witnessed assertiveness and confidence with a sure hand mapping my body with his sharpie pen. He made me feel at ease with his good sense of humour and music.
My breast cancer journey is at long last over and I am quite happy with the final results. I feel rejuvenated and have gained my confidence back. I am so glad that I didn’t hesitate with my initial decision to go forward with the breast reconstruction. Thank you so much Dr. Shortt.

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