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.

Testimonials

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.

Nicest doctor ever

Dr. Shortt made my experience so wonderful and easy, he listened to all my concerns and was so helpful with everything. I had small implants put in to correct my tuberous breast and didn’t want too much of a visible change in size, he did exactly that and was so helpful throughout the whole process and made things very easy. I can’t thank I’m enough!

Amazing Experience with Dr. Shortt

I had an amazing experience with Dr. Shortt and his staff. I am so thankful to have had such a skilled surgeon and I am extremely happy with the results and I am glad I went through with the procedure/ chose Dr. Shortt as my surgeon. When I went for my pre-op check-up with my GP he asked who my surgeon was and when I told him it was Dr. Shortt he said that Dr. Shortt is a very good surgeon/ “one of the best.” The consultation process was excellent, I had more questions than the average patient. I asked specific questions about the procedure and the techniques that he uses for the surgery and he was more than happy to answer all my questions and let me know that I could come back for further consultations if I had more questions etc.

I highly recommend Dr. Shortt

I highly recommend Dr. Shortt. I recently had laser surgery on my face and am very pleased with the results. Dr. Shortt was patient, understanding and answered all my questions during our consultation. I later had some concerns about the surgery and Dr. Shortt listened to them and modified the procedure for me. I felt completely confident in his skill, expertise and professionalism and am very glad I went ahead with the surgery.

Feel and look better than ever before.


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