American Society of Plastic Surgeons
For Medical Professionals
5 years ago

I just want my confidence back

I have been researching for a while but I can't make up my mind on whether it would be better to have a breast augmentation with silicone or a fat transfer. I had 4 kids and one breast is a full C, while the other is maybe a B (or full A). I would like to have a consultation but I haven't seen any that do Pro Bono consults in (or near) SC. I just want my confidence back.

Procedure: Breast Augmentation
Location: Columbia, SC

Replies 5

Gary Culbertson
ASPS Surgeon
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Great question. The predominate issues with fat transfer to the breast are most commonly costs, adequate reserves of fat to transfer and breast ptosis or sagging. Fat transfer of the breast works, there can be a limited amount of fat that can safely transferred per setting and often the increase in cup size is between 1/2 to 1 cup size after each surgical procedure. Multiple fat transfer settings can be and are often required. Fat transfer to breast can be as expensive a saline breast augmentation per each surgical procedure. In addition sagging of the breast can be more common in women who have had multiple children and should be addressed to produce the appealing breast. Consider an ASPS member in your area familiar with fat transfer. They are experts in breast surgery. Best,

Gary R Culbertson, MD, FACS

Debra Johnson
ASPS Surgeon

Fat transfer, if appropriate for you, would result in two breast that are more similar (rather than one with an implant and one without). As Dr Culbertson mentioned, you have to have enough fat elsewhere to donate and it sometimes requires more than one treatment. Use the Find-A-Surgeon tool to locate ASPS members near you, then make some calls asking whether the doctor does dat transfer for breast enlargement (not all do). While the consult may not be free, remember you are receiving the doctors expert opinion and their time which is valuable.

Jon Ver Halen

Hello and thank you for your excellent question. I agree with most of the comments on this thread -- the decision to use an implant versus fat transfer really depends on the goals for your procedure, the size and shape of the breast you want (relative to your current breast), willingness to have an implant placed (versus fat), and cost. It is best to answer your question during a face-to-face evaluation, when you can discuss your goals and expectations for the procedure, and you can have a physical examination to evaluate for that procedure. I recommend that you find a board-certified, or board-eligible plastic surgeon with whom you are comfortable. Be sure to have all of your questions answered during a face-to-face meeting with your surgeon, and review before and after pictures of similar patients whom have had this procedure. Good luck!

Gregory Sexton
ASPS Surgeon

I am not aware of anyone in the Columbia area doing fat transfers for breast augmentation. The idea of having natural tissue transferred is nice, but you will get resorption, you need enough fat to transfer, and expect to do it at least twice to get the volume you want, and to touch-up any asymmetry after resorption. Augmentation with saline or silicone implants will probably give you the results you want, with less procedures and less expensive.

Good luck

Nelson Castillo

Thank you for sharing your excellent question. Although nothing replaces an in-person examination I would hazard that a fat transfer would be a great option to improve upon symmetry between your breasts while an augmentation +/- a fat transfer would be a better option if looking to increase both breast sizes. Although pro bono work is unlikely, seek out academic plastic surgery practices in your area that have resident clinics as the cost may be less.


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