Breast augmentation by fat transfer (lipofilling)
These days, breast augmentation is one of the most frequently performed surgeries in aesthetic surgery. The reasons for it vary greatly from patient to patient. Breast augmentation with autologous fat from your own body (lipofilling) is often perceived as more natural, and it appeals more to women who want a moderate enlargement and are not keen on a silicone gel implant. Furthermore, lipofilling is eminently well suited to compensating for defects of volume and shape (e.g. in cases of congenital malformations of the breast such as asymmetry and tubular breast deformities, or as a result of previous operations), or to mitigate the visibility or palpability of silicone gel implant rims that may be beginning. The advantages of this method lie above all in the possibility of tissue modulation, in a natural appearance, and in an improvement of the quality of the skin. Because it is the patient’s own fatty tissue that is used, the breast continues to feel natural.
A reasonable amount of time before the operation, it is obligatory to have your breasts screened by your gynaecologist with medical imaging (as recommended by your specialist, e.g. by ultrasound).
Procedure for breast augmentation by autologous fat transfer
At the consultation, we look very closely at your individual wishes and take the time needed to explain everything to you precisely. First, we conduct a detailed anamnesis to check for possible risks, and discuss your ideas, particularly with a view to what is actually feasible. After that, we carry out a precise examination of your breasts and the potential sites of liposuction, and take all the necessary measurements.
In a breast augmentation with fat from your own body, fatty tissue is removed from your ‘problem areas’, which can of course have some nice side effects too. With a special set of instruments, the fatty tissue is then put through a sterilisation process and introduced into the target region in several layers. A prerequisite for this is that sufficient quantities of fatty tissue are available in the first place. In most cases, only part of the fat implanted in the target zone actually manages to make the connection to the local blood vessel system. For you, that means that the larger you wish your breasts to be after completion of all the treatment, the greater the number of sessions that may be required.
One of the clear advantages of lipofilling is that excess fat is removed from places where you don’t want it. Another is that the operation can be repeated several times until the desired volume has been achieved. This calls for transparent planning. At the same time, using your own body fat enables your breasts to be given an extremely natural and beautiful shape. Often enough, thanks to the newly introduced stem cells (up to 30% of the fat cells), the firmness and circulation in the skin are improved, and thus also the overall tissue quality of the breast.
In liposuction, the amount of fatty tissue required for the breast enlargement is removed. If you wish, we can of course also remove more fat from other regions. As in normal liposuction, the fat is removed from the relevant parts of your body using a vibration system. Subsequently, it is processed in a special filter system. With the aid of a fine cannula, the filtered fat is introduced as droplets into the various areas and layers of breast tissue (skin, subcutaneous fatty tissue and muscles), which have a good blood supply. This enables us to give your breasts a very natural shape. Subsequently, the transplanted fat cells must make the connection to the vascular and micro-circulation systems of the breast tissue. As to how much fatty tissue is actually accepted at the end of the process, that varies a great deal from patient to patient. In our experience, and according to recent studies, however, an average of approx. 60 per cent of the implanted tissue is integrated. As a rule, 100 to 200 ml of fatty tissue is introduced per breast in each session. In cases of unevenness or asymmetry, or to emphasise the patient’s cleavage, a smaller amount of fat is usually sufficient. In patients who already have large breasts, so that there is already an appropriately large amount of tissue available, more than 200 ml of fat can be infiltrated. And sometimes the quantity that is infiltrated can be increased in the subsequent sessions.
If your own body fat is not sufficient to fulfil your wishes, lipofilling can be combined with the deployment of implants.
The incisions at the liposuction sites are approximately half a centimetre wide, and in the breast area, mostly even smaller than that. It goes without saying that we try to make as few incisions as possible and thus cause as little scarring as possible. If we can, we use skin folds or, if available, old scars for access.
The duration of the operation varies very much from patient to patient. It depends on how much fat is removed from how many zones in the liposuction, and how much of it, finally, is to be transplanted into the patient’s breast.
After breast augmentation by autologous fat transfer
After the surgery you will be taken to our recovery room, where you will be looked after and monitored by a qualified member of our staff. The necessary pain therapy will be adjusted to fit in with your requirements.
As the surgery is performed under semi-conscious sedation (analgosedation), you will be able to go home the same day, though it will be necessary for you to have a trusted adult at your side who can keep an eye on you and take appropriate action if there is an emergency.
The first follow-up check with a change of dressing takes place the next day. In the first few days, fluid may continue to escape from the small punctures at the places where the fatty tissue has been removed. However, that is normal and salubrious, and it need not worry you.
In most cases the surface wounds will have healed after as little as a week. As a rule the skin incisions are only closed by means of an adhesive, not sutured. If we do decide in favour of sutures, we will use very fine, thin suture material, which can be removed after about seven days, at the second check-up.
Further check-ups and dressing changes then follow at regular intervals. At these subsequent examinations, depending on the findings, we also make appropriate recommendations on the right kind of scar care.
For 6 weeks, you will have to wear compression underwear in the area of the liposuction. During this time you also have to wear a bra which supports your breast, but doesn’t restrict you too much. The patient’s breasts are often taped with a special tape dressing in the first one to two weeks.
During that time you should also take it easy physically and not do any sport. Depending on the findings and depending on which zones the fatty tissue was taken from, you may be able to start back in after 2-3 weeks with long walks or similar. But that is something we always decide about quite individually on a patient-to-patient basis. After that, you will be able to resume gentle sports activity and then increase it gradually. At the beginning you should definitely avoid sports of the kind that put a lot of pressure on your breasts or cause vibrations.
We also recommend you to sleep on your back only during the first few weeks after the operation, so as to protect the sensitive breast tissue.
As for the final result, you can expect it after approximately four to six months. From then on, it would also be possible to repeat the lipofilling in a fresh session.
How long does the surgery take?
As a rule the surgery takes 1.5 to 3 hours, depending on how many regions fat is being removed from and how much fat is being transplanted to the breast.
What kind of anaesthetic is required for a breast enlargement by lipofilling?
This out-patient surgery is performed under semi-conscious sedation, which means that you can breathe independently and are responsive. Having said that, as the surgery takes place you yourself will perceive the situation as pleasant and will not normally have any clear recollections of it. You will be monitored throughout by our anaesthesiological specialist.
What complications can occur?
There are risks attached to any surgery, from the anaesthetic and from the surgery itself. However, with the right technique and our expertise, we minimise all these risks and preclude complications to as great an extent as possible.
Having said that, complications can also occur after the procedure. Reconstruction processes can take place in the breast tissue after lipofilling, such as can lead to fibrosing, calcifications or even oil cysts. However, most changes of this kind are so minor that the patient doesn’t even notice them, and they don’t have any impact on her health either.
In very rare cases, there is hardly any acceptance of the transplanted fatty tissue by the patient’s body, or indeed it is not accepted at all, and broken down again as a consequence. By contrast, it is of course also possible for the integration rate to be above the average of 60%.
You will find a detailed description of the possible complications here.
What makes the right kind of candidate for a breast enlargement with the body’s own fat?
Transplantation of fat from your own body is very suitable for the compensation of asymmetries or congenital malformations of the breasts, because in these cases the breasts can be given a much better and more natural shape than in enlargement by means of implants. However, general enlargement of the breasts by lipofilling can only be undertaken if there is sufficient fatty tissue in other parts of your body which can be removed and processed.
What kind of patient is unsuitable for a breast augmentation with autologous fat transfer?
For patients who do not have sufficient depots of fat and patients who envisage breast sizes which cannot be reconciled with the quantities of body fat actually available for transplantation, we do not recommend autologous transplantation of fat. Also, if you are currently in a phase in which you are deliberately losing weight, you should wait until you have reached your target weight and kept it stable for at least six months, because as soon as you begin to lose weight after the operation, the transplanted fat in your breast will also diminish.
After pregnancy or weaning you should wait until the nine-month period of post-partum recovery is over, because this is a time in which there may be major hormonal influences and reconstruction processes in the tissue of your breasts.
During the examination at our initial interview we can explain this to you if necessary and inform you about other options for breast enlargement.
How long will a fat transfer breast augmentation last?
After approximately four to six months, the reconstruction processes in your breasts will be complete. After that, we can assess how much of the fatty tissue has been accepted and whether or not the lipofilling needs to be repeated. Aging processes, major fluctuations in weight or hormonal swings (e.g. in the menopause or in pregnancy) may also have an influence on the result as time goes on.
Can I combine a breast enlargement by autologous fat transfer with a breast lift?
If you wish to have a breast lift, it is better to have it performed separately, after a breast enlargement by lipofilling. It is often the case that the improvement in the tissue quality already brings about a certain lifting effect. We will be happy to advise you on this in detail at our initial interview.
When can I get back to doing sport?
You should avoid activities which cause vibration of the breasts or put a lot of tension on the scars, for example jogging. After some six weeks you can begin with gentle sport and then gradually increase it. Until then, you should take it easy and try to avoid too much movement or vibration on your breasts.
What would a breast augmentation by lipofilling cost?
The costs of a breast augmentation with fat transfer start at about €5,000. If the fat is to be taken from more than one zone, the price will rise accordingly. On the bottom line, the overall sum is made up of the costs of the anaesthesia, the liposuction and the transplantation of your body fat, and the post-operative care.
Will my health insurance provider be prepared to meet the costs of a breast enlargement by fat transfer?
No, a breast enlargement by lipofilling is an surgery performed for purely aesthetic reasons.
However, if you are planning a breast equalisation because of a congenital malformation in which the difference in volume between your breasts is greater than 50 per cent, you may apply to your health insurance provider to have the costs covered.
Is a breast augmentation by lipofilling suitable for women with cancer?
This procedure is only suitable for women with cancer under certain clinical conditions. Consent from the gynaecologist or oncologist in charge is also required in such cases. At the moment, there are still studies being carried out on this. In exceptional cases only, the costs are covered by the health insurance provider in the out-patient sector. As to whether it might be possible for you to make an application for that, and if so under what circumstances, we will be glad to discuss this with you in detail at a personal meeting.
DURATION OF OPERATION: 1.5 – 3 hours
ANAESTHETIC: semi-conscious sedation
HOSPITALISATION: out-patient, or in-patient for 1 – 2 days
PAIN LEVEL: low
AFTER-TREATMENT: compression underwear for 6 weeks
PRESENTABILITY, RETURN TO WORK: after approx. 2-3 days
SPORT: after approx. 3 – 6 weeks, full performance after 12 weeks
COST: from €5,000
Ask our advice.
We’ll be glad to provide you with detailed information about this treatment. Simply get in touch with us now and obtain advice at an individual and absolutely personal level.
+49 30 - 94 041 144