dranupdhir@hotmail.com 
The majority of women who look into breast enhancement are not aiming to make a huge difference. They are looking for a modest, natural enhancement: more full upper poles, improved proportion or restoring lost volume caused by pregnancy or weight loss. In these patients, fat grafting might be a more suitable option than implants. It does not involve the use of foreign material, does not create large incisions and provides high-quality results that are soft and feel like the patient's own tissue.
This is a combined procedure of liposuction and fat transfer. Fat is stemmed from a donor area on the patient's body, normally the abdomen, flanks or inner thighs, cleaned to make sure that just viable fat cells are injected into the breast in numerous little deposits to create volume uniformly.
The two-fold advantage is a factor in the attraction. In a single operation, patients burn fat from one body part to another.
Dr. Anup Dhir uses fat grafting with adipose-derived regenerative cells to supplement the fat graft with adipose-derived regenerative cells. These cells promote graft survival and have a beneficial impact on the overlying skin, enhancing texture and quality as time goes by. This is not done by standard fat grafting. The enrichment of ADRC is a more technical process and not all centres conduct this.
Women who undergo breast enhancement with fat transplantation are those who:
Fat grafting is not intended to correct excessive sagging of the breast. An esthetic patient with ptosis requires a breast lift (either at the time of the lift or as an additional procedure). That's important to clarify when consulting, prior to setting any expectations.
It is carried out under general anesthetic and is a day case procedure.
An amount of 150-350 ml of processed fat is usually possible to transfer each breast in one surgery, depending on the size of fat source and the breast pocket. Females wishing for greater fullness than a single procedure can provide can receive a repeat procedure after the initial graft has matured, typically after three months.
For the first 2-3 weeks, there may be swelling at the donor site and at the breasts. There is a certain amount of fat loss that is due to the body absorbing some of the fat that is transferred over a span of 6-8 weeks. This is why experienced surgeons will transfer a little more than the volume that is being targeted.
Any fat that is left over turns into permanent living tissue. It reacts in the same way as normal body fat does – with small amounts of weight gain, volume increases, and large amounts of weight loss, volume decreases.
Most patients are able to return to working at a desk within 1 week. To allow for adequate healing of the grafted tissue, pressure during the first six weeks is avoided by avoiding the use of underwire bras. The results of the final are known at 3 months.
Implants provide more consistent volume and the volume can be measured before surgery. They are appropriate for patients who desire a greater change than what can be provided by fat grafting in a single procedure.
Fat grafting results in a softer, more natural outcome, and no implant issues: no risk of capsular contracture, no risk of implant rupture, no time for implant replacement. There's a trade-off, though, because the amount that can be made from every donor fat and the amount that the breast will take.
Some patients get both: implants for volume, fat grafted on top of the implant for a softer edge and feel. This is especially effective in the case of thin patients where an implant would look unnatural.
Dr. Anup Dhir is a Senior Consultant Plastic and Cosmetic Surgeon at Indraprastha Apollo Hospital, New Delhi with 40 years of experience in breast surgery. He performs ADRC enriched fat grafting breast augmentation and he recommends combined implant and fat for the patient.
Medically reviewed by Dr. Anup Dhir, MBBS, MS, MCh (Plastic and Reconstructive Surgery), FECSM.
Leave a request to connect to Dr. Anup Dhir for an Appointment.