Stephen McCulley, Reconstructive and Aesthetic Surgeon. MBChb, FCS(SA)Plast, FRCS(plast)

Fat transfer breast augmentation—how it works and what to expect

Fat transfer breast augmentation (also known as autologous fat transfer) is a relatively new breast augmentation technique. It involves removing fat from the buttocks, thighs, hips and/or stomach and injecting it into the breasts.

Fat transfer breast augmentation is ideal for women who want a small to moderate increase in breast size—an increase of up to one cup size is realistic.

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How fat transfer breast augmentation works

Fat injection breast augmentation surgery involves taking fat from the thighs, buttocks, hips and/or the stomach and injecting it into the breasts to add volume.

There are two phases to the procedure:

  1. Your surgeon will remove fat from your stomach, buttocks, hips or thighs using liposuction techniques.
  2. A special machine prepares the fat for injection by separating it from blood and other fluids. Your surgeon then injects the prepared fat into your breasts through tiny holes in your skin.

As the needle and syringes are so small, it’s unlikely you’ll need stitches.

Phase 1—Liposuction

Liposuction is the process of removing stubborn fat from areas of the body such as the bottom, thighs, hips and stomach. Often, patients have tried to lose fat from these areas through diet or exercise but it hasn’t worked.

During the procedure, the surgeon uses blunt needles to suck out the fat through small incisions of around 2mm–3mm in your skin.

The procedure is performed under local or general anaesthetic—depending on what’s most suitable for you—and will take up to two hours to complete. How much fat the surgeon removes depends on what fat you have available and how much is needed to increase the size of your breasts.

Phase 2—Fat injection

The fat transfer procedure involves using a special machine to separate the fat from other liquids, such as blood. The surgeon then uses fine needles to inject the fat into your breasts. This part of the procedure should take around two hours.

In total, you can expect the entire procedure to take four to five hours.

Pros and cons of fat transfer breast augmentation

The procedure has the following benefits:

  • It doesn’t involve major surgery and the risks that come with it.
  • You’ll have fat removed from your buttocks, thighs, hips and/or stomach, giving you a slimmer figure.
  • The results are extremely natural-looking.
  • As the fat is taken from your body, there’s no chance of you having an allergic reaction or your body rejecting the fat.

The main downside of this procedure is that most women will only see an increase of up to one cup size. And although the procedure is less risky than major surgery, there are still risks involved. You can read more about the potential complications of the procedure here.

You can find out more about what liposuction involves here, including before and after images.

If you’re considering the pros and cons of fat transfer injections compared to breast augmentation with implants, you can find out all you need to know about breast implant enlargements here.

How much does liposuction and fat transfer to the breasts cost?

The cost will depend on a number of factors, including:

  • the number of areas treated with liposuction
  • whether top-ups are included
  • whether consultation and follow-up fees are included
  • the experience of the surgeon

According to the NHS, fat transfer procedures cost between £2,000 and £6,500, depending on which area of the body is treated. However, the prices of some London clinics start at £6,500, so you may find that where you are in the country affects the price as well.

If you have Stephen McCulley carry out the procedure, you can expect to pay between £2,600 for small area fat transfer up to and £6,047 for full breast fat augmentation.

How does the cost compare to implants?

Fat transfer breast augmentation is similar in costs to breast augmentation with implants—with Stephen McCulley, those costs start at £5,900.

The results of the fat injection procedure are permanent, whereas breast implants often last for around 10 years before they need to be changed. These are other factors to consider when weighing up the pros and cons of the procedure.

Who’s the ideal candidate for fat transfer breast augmentation?

As the process takes fat from your bottom, thighs, hips or stomach, you’ll need to have sufficient fat in these areas for the surgeon to be able to remove it and inject it into your breasts. If you’re very slim, this may not be the best procedure for you.

You’re an ideal candidate for fat transfer breast augmentation if you:

  • want to increase your breast size by one cup
  • are a healthy, stable weight but have stubborn fat around your hips, thighs, buttocks or stomach
  • want to increase the size of your breasts without changing their shape
  • don’t plan to have children, or more children
  • have breast asymmetry (different-sized breasts), as the procedure can be done on just one breast
  • want results that last without having to undergo further operations—for example, augmentations with implants last around 10 years
  • have thin skin—if you don’t have enough breast tissue to cover a breast implant properly, you may be able to see or feel it under the skin. Fat transfer breast augmentation would be a more suitable procedure.

You’re not a suitable candidate for fat transfer breast augmentation if you:

  • want to significantly increase your breast size
  • have a very slim frame or plan to lose weight in future
  • have lost large volumes in your breasts
  • are planning to have children in the future—it’s best to wait until you’ve completed your family before undergoing breast enlargement
  • have sagging breasts—this might be due to breastfeeding, age or weight loss. Fat transfer adds volume to breasts but doesn’t change their shape. If you’re worried about the shape of your breasts, the best way to correct sagging is with a breast uplift, or an uplift with augmentation.

If you feel breast augmentation with implants might be a more suitable surgery for you, you can read more about breast implant surgery here.

What are the side effects and risks of having fat transfer breast augmentation?

Fat transfer augmentation is actually two procedures in one (liposuction and breast enlargement). Making incisions in more areas of the body does increase the risk of infection and other effects of surgery such as deep vein thrombosis (DVT), haematoma and bleeding. However, it’s important to remember fat transfer breast augmentation is a low-risk operation.

Side effects and risks of the liposuction stage of fat transfer breast augmentation

There are risks associated with liposuction, and some patients experience unpleasant side effects, including:

  • bruising
  • pain
  • numbness
  • swelling
  • dimples and ridges making the surface of the skin look uneven
  • sagging skin—patients over 40 may experience this in areas from which large volumes of fat have been removed

As with all surgery, there’s a risk of infection where your skin has been broken. If you do develop an infection, it can be very painful and cause scarring.

Side effects of the fat injection stage of fat transfer breast augmentation

Calcification

This happens when the fat that’s been transferred dies and forms microcalcifications, which are small deposits of calcium.

Microcalcifications are one of the signs specialists look for during a mammogram. If they find a lot of them in the same area of your breast, this can be a sign of early breast cancer. Unlike many breast cysts or tumours, microcalcifications can’t be felt through the skin.

Calcifications can mimic the early stages of cancer on a mammogram, but experienced radiologists will be able to tell them apart.

Fat necrosis

Sometimes, the fat injection procedure can damage the breast, causing it to develop an area of dead tissue. This is known as fat necrosis.

Fat necrosis can cause non-cancerous lumps or hard areas to appear in the breast. These can be felt through the skin and appear on mammograms and ultrasound scans. In some cases, the lump may need removing.

Is there a link between the fat injection procedure and breast cancer?

The procedure doesn’t increase the risk of breast cancer but it could lead to complications in diagnosing the disease, or create lumps in the breast that a doctor would need to assess.

If you have a family history of breast cancer or have a higher risk of developing it, make sure you speak to your surgeon about your concerns. Stephen McCulley’s technique involves injecting the fat under the skin and breast tissue rather than into the breasts themselves, which lessens the risk of the fat affecting the tissue.

We have a general guide to reducing the risks associated with surgery here. You can find out more about potential complications related to fat transfer here.

Does fat transfer breast augmentation hurt?

You won’t feel any pain during the procedure as you’ll be given either local or general anaesthetic. However, you’re likely to feel sore in the weeks after the operation but you’ll be given pain medication to help manage this.

Does fat transfer injection for breast augmentation work?

Fat transfer breast augmentation is an effective way to increase the size of your breasts by around one cup size.

The exact results can’t be determined in the same way as they can with a breast augmentation with implants. This is because it’s difficult to predict how much of the fat transferred to the breast will remain in place and how much your body will absorb.

Why is the increase in breast size so small?

Your body will reabsorb around 50% of the fat that’s injected into your breasts. This usually happens within the first few weeks after the procedure, but it can take up to four months for you to see the final results.

The actual amount of fat the body reabsorbs varies from patient to patient. If your body absorbs a lot of fat, you may need a top-up procedure if the results do not meet your expectations. There are costs associated with this.

Why does the body reabsorb some of the fat?

When fat cells are removed from your body via liposuction, they’re still alive. However, some of the cells will die during the following phases:

  • Removal—when fat is taken out of the body using liposuction techniques
  • Cleaning—when the fat is prepared for reinjection
  • Injection—when the fat is injected into the breasts
  • Recovery—some fat cells will die after they’ve been reinjected into your body

This can mean the initial results of the procedure are not the same as the final result—some of the fat will act as a semi-permanent ‘filler’, rather than being permanently grafted on to living cells. Your body will reabsorb most of these cells and flush them out as waste. The remaining cells that survive will be permanent.

Although uncommon, losing fat from your breasts as a result of your body reabsorbing it can cause them to look uneven. If this happens, one breast may need to be injected with more fat to achieve a uniform result.

An experienced surgeon will do the following to make sure your breasts retain as much of the fat as possible:

  • Harvest the fat under low pressure to prevent an excessive number of fat cells dying.
  • Evenly distribute the fat into several sites in the breasts. Doing this gives each fat cell the best chance to connect with the existing fat cells within the breast.

Speak to your surgeon about the results you can expect from your procedure.

Are there any clinical studies that show this procedure works?

A 2014 study of 105 women who had the procedure found all of them showed a “significant improvement in their breast size and shape postoperatively, and the breasts were soft and natural in appearance.” (Breast Augmentation With Autologous Fat Injection Fa-Cheng Li, MD, PhD, Bing Chen, MD, and Lin Cheng, MD)

How long do the results last? Are they permanent?

The results of injecting fat cells into the breasts are permanent—once the fat has been transferred it acts like the natural fat that’s already present in the breasts. The body doesn’t reject the fat as it assumes the new tissue was produced within the breast.

Fat transfer procedure recovery—what you can expect after the procedure

As this is a non-invasive procedure, recovery time is short and you can expect to go home the same day.

However, there are still a number of precautions you’ll need to take in the first few weeks after the procedure to make sure you recover safely. You can read more about recovering from having fat injections here.

Frequently asked questions on fat transfer breast augmentation

Does fat transfer breast augmentation affect breastfeeding?

In most cases, having a breast augmentation with fat transfer won’t affect your ability to breastfeed. However, as this is a relatively new procedure, the long-term effects of fat transfer augmentation on the ability to breastfeed aren’t fully understood.

As pregnancy and breastfeeding can change the shape and size of the breasts, it’s advisable to wait until after you’ve completed your family before you undergo the procedure.

You can find out more about breast augmentation with implants and the impact on breastfeeding here.

Can the procedure be used for reconstruction after breast cancer surgery?

Yes, fat transfer can be used to reconstruct breasts after breast cancer surgery. However, fat transfer augmentation is often used in conjunction with implants.

Often, having a mastectomy involves removing a large amount of breast tissue, which can mean there isn’t enough tissue to cover the implants and achieve natural-looking results.

Fat transfer can increase the amount of breast tissue available and so create enough tissue to cover the implants.

Alternatively, the fat transfer technique can be used as a way of correcting minor differences between the shape and size of the breasts after reconstruction, or to add volume to areas of the breast that have lost volume due to a lumpectomy.

Is fat transfer breast augmentation available on the NHS?

Cosmetic fat transfer breast enlargement isn’t usually available on the NHS. However, the procedure is often performed on the NHS as part of breast reconstruction surgery after having a mastectomy or lumpectomy.

Can I have breast lift surgery and fat transfer injections?

Yes, you can have fat injections to increase the volume in your breasts after having a breast lift. If you have sagging breasts which have lost volume due to weight loss or breastfeeding, fat injections alone won’t rectify this as they don’t alter the shape of the breasts, they just add volume. You’ll need to have your breasts lifted before having a fat transfer augmentation.

What does an autologous fat transfer mean?

Autologous is the technical term to describe a fat transfer using fat from other areas of the body. It’s the same procedure as a fat transfer breast augmentation.

Further resources

For more information on the fat injection procedure, read our dedicated page to fat injects for breast augmentation.

You can read more about the liposuction procedure and see some before and after images here.

In the Questions to Ask section of the Advice Centre you can find common questions and answers on a range of breast augmentation procedures.