Autologous fat breast enlargement (lipofilling)
Breast enlargement is one of the most common procedures in aesthetic surgery today. The reasons for this are very individual. Breast enlargement with autologous fat (lipofilling) is often perceived as more natural and is aimed primarily at women who have a moderate desire for enlargement and a Silicone implant is rather annoying. Lipofilling is also ideal for filling volume and shape defects (e.g. in congenital breast malformations such as asymmetries and tubular breast deformities or after previous operations) or for reducing visible and palpable silicone implant edges. The advantages of autologous breast enlargement are primarily the possibility of tissue modulation and a natural appearance as well as an improvement in skin quality. By using your own fatty tissue, the breasts continue to feel natural.
A preventive breast examination by your gynecologist with imaging diagnostics (according to the specialist doctor’s recommendation, e.g. ultrasound) is obligatory within a reasonable period of time before the breast operation.
Procedure for breast enlargement with fat from your own body
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 enlargement 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 enlargement with fat from your own body
After the operation 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 operation 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 breast augmentation with fat transfer take?
The procedure usually takes between 1.5 and 3 hours, depending on how many areas of the body require liposuction and how much fat is transferred to the breasts.
What type of anaesthesia is required for breast augmentation with fat transfer?
This outpatient breast procedure is performed under sedation (twilight anaesthesia), which means that you can breathe independently and remain responsive. However, you will generally find the surgical experience comfortable and usually have little or no clear recollection of the procedure. Throughout the operation, you will be monitored by our specialist anaesthetist.
What complications can occur after breast augmentation with fat transfer?
Every surgical procedure involves risks, whether associated with the anaesthesia or the operation itself. By using appropriate surgical techniques and drawing on our expertise, we aim to minimise these risks and prevent complications as far as possible. Nevertheless, complications may also occur after surgery.
Changes in the breast tissue following lipofilling may occasionally lead to fibrosis, calcifications or even oil cysts. Most of these changes are so small that patients do not notice them, and they generally have no adverse effects on health.
In very rare cases, little or none of the transplanted fat tissue is retained and it is gradually reabsorbed by the body. Equally, the fat survival rate may exceed the average of 60%.
You can find a detailed description of potential complications here.
Who is suitable for breast augmentation with fat transfer?
Autologous fat transfer is particularly suitable for correcting breast asymmetry or congenital breast deformities, as it allows the breast shape to be adjusted in a natural-looking way and can offer advantages over breast augmentation with implants in these cases. Breast augmentation using fat transfer is only possible if sufficient fatty tissue can be harvested from other areas of the body and prepared for transplantation.
Who is breast augmentation with fat transfer not suitable for?
We do not recommend autologous fat transfer for patients who do not have sufficient fat reserves or whose desired increase in breast size cannot be achieved with the amount of fat available for transplantation. If you are currently trying to lose weight, you should also wait until you have reached your target weight and maintained it for at least six months. This is because losing weight after breast surgery can also reduce the volume of the transplanted fat in the breasts.
Following pregnancy or breastfeeding, you should allow approximately nine months for the breast tissue to recover, as significant hormonal influences and changes in the breast tissue may still occur during this period.
During your initial consultation and examination, we will explain any relevant limitations and discuss alternative breast augmentation options where appropriate.
How long do the results of breast augmentation with fat transfer last?
After approximately four to six months, the tissue remodelling processes in the breasts are generally complete. At this stage, we can assess how much of the transferred fat has been retained and whether an additional lipofilling procedure may be necessary. The natural ageing process, significant weight fluctuations and hormonal changes (e.g. menopause or pregnancy) may affect the results over time.
Can I combine breast augmentation with fat transfer and a breast lift?
A breast lift is generally better performed after breast augmentation with fat transfer. In many cases, improvements in tissue quality may already produce a certain lifting effect. We will discuss this with you in detail during your initial consultation.
When can I exercise again after breast augmentation with fat transfer?
You should avoid activities that cause the breasts to bounce or place significant tension on the scars, such as jogging. After approximately six weeks, you can usually begin light exercise and gradually increase your activity level. Until then, you should avoid physical exertion and minimise movement of the breasts.
How much does breast augmentation with fat transfer cost?
The cost of breast augmentation with fat transfer depends on your individual circumstances and the extent of the treatment required. In particular, the number of body areas to be treated may influence the overall cost. Following a personal examination and consultation, we will provide you with an individual cost estimate.
Will my health insurance cover the cost of breast augmentation with fat transfer?
Generally, no. Breast augmentation using lipofilling is usually considered a purely aesthetic procedure.
However, in cases of breast asymmetry caused by a congenital deformity, where the difference in volume between the breasts exceeds 50%, an application for health insurance coverage may be submitted.
Is breast augmentation with fat transfer suitable for women with cancer?
For women with cancer, this procedure is only suitable under certain clinical conditions. Approval from the treating gynaecologist or oncologist is required. The available scientific evidence is still considered incomplete. Health insurance only covers the costs of this procedure in outpatient settings in exceptional cases. We will be happy to discuss in detail during a personal consultation whether an application for cost coverage may be appropriate in your individual circumstances and under what conditions.
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
COSTS: Depending on individual circumstances; a cost estimate will be provided following examination and consultation.
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