Similar to a breast augmentation with implants, breast augmentation with fat grafting requires detailed planning based on the patient’s anatomy and aesthetic ideals. Dr. Chang carefully assesses your breasts for asymmetries, how to correct those asymmetries, and how to best perform the fat grafting procedure to deliver the natural, beautiful results you are looking for. 

Breast augmentation or augmentation mammaplasty aims increase the size of the breasts and achieve an aesthetic contour of the breasts to have natural upper pole fullness, cleavage, and a rounded but defined outer breast shape. Young patients with smaller-than-desired breasts and patients who have experienced breast deflation from pregnancy or weight loss are excellent candidates for this surgery. While breast augmentation is more commonly performed with implants, fat grafting is an excellent option for patients who would like to avoid permanent implants and have sufficient excess fat tissue elsewhere for the degree of breast augmentation they desire. 

Overview & Why Choose
Dr. Chang

Breast Augmentation
(Fat Grafting)

  • Small Breasts – Young patients with smaller than desired breasts. 

  • Deflated Breasts – Patients who have experienced breast deflation from pregnancy and/or weight loss and want to restore the youthful volume and contour of their breasts. The nipple-areola complexes must be properly and symmetrically located, and the skin quality has to be excellent, otherwise patients are better suited for a breast augmentation-mastopexy.  

  • Breast Asymmetry – Patients with asymmetric breast sizes can benefit from a breast augmentation with different sized implants. The nipple-areola complexes must be relatively symmetric. For more significant cases of asymmetry, patients might be better suited for a breast augmentation-mastopexy.

  • Sufficient Peripheral Adipose Tissue – Patients need to have sufficient excess adipose tissue as the source of the fat to augment the breasts. The most common locations include the abdomen, flanks, and thighs, though other locations can be used. If you do not have enough excess fat, you may be better suited for a breast augmentation with implants. 

  • Healthy Patients – Healthy, non-smoking patients without major medical conditions that would make surgery or general anesthesia unsafe are candidates for this surgery. Conditions that pre-dispose to increased complications such as diabetes, vascular disease, autoimmune conditions, immunodeficiencies, etc. are still candidates for surgery but require additional pre-operative counseling and optimization.

  • Realistic Expectations – Dr. Chang views surgery as a partnership between the patient and him. It is important trust and confidence go both ways. Together, we will discuss your goals and if we can reasonably achieve those goals based on your anatomy.

Who Is a Candidate?

  • Breast Examination – Dr. Chang will perform a physical examination of your breasts. This will include measurements of the size, location, and symmetry of the breasts and nippleareolar complexes. Dr. Chang will assess the skin quality, the weight/volume of excess breast tissue relative to your desired size, and the positions of the nipple areolar complexes to help determine the best surgical approach. Dr. Chang will palpate for any noticeable breast masses.

  • Clinical Photographs – Clinical photographs from multiple views will be taken of your breasts. These photos are used to help plan for your individualized surgery and compare before and after surgery. No photographs will be published online without your written consent.

  • Imaging Studies – Based on your age, genetic risk, and personal and family history of breast conditions or tumors, you may be recommended for a mammogram, ultrasound, CT, or MRI study. If a lesion is identified, you may be recommended for a biopsy and a consultation with a breast oncologic surgeon prior to proceeding with surgery. 
  • Medical Evaluation – Dr. Chang will review your medical conditions, medications, prior surgeries, and personal and family history of breast diseases, masses, and cancers. Some patients may be referred to their primary care doctor or a specialist to ensure you are medically optimized for a safe surgery under general anesthesia and post-operative recovery. Because this is an elective surgery, some patients may be recommended to optimize certain parameters before proceeding with surgery. This may include weight loss, smoking cessation, nutrition optimization, resolution of an acute illness or condition, etc.   

Pre-Operative

  • Incisions – You will have multiple, small ~ 5 mm incisions at both the liposuction sites and the breast fat grafting sites. Dr. Chang strategically conceals the incisions in areas that are normally covered by your bra and underwear. 

  • Liposuction – Dr. Chang will aesthetically contour your abdomen, flanks, back, thighs, etc. while also harvesting the fat to be used to augment the breasts. Dr. Chang uses specialized techniques to ensure safe and effective harvest of healthy fat cells while minimizing morbidity to the donor areas. 

  • Fat Grafting – The harvested fat is injected into your breasts for augmentation and aesthetic contouring. This step is critical as improper technique can increase the risk of aesthetic displeasure and/or complications. 

Technique

  • Pain Management & Medications – Local anesthetic (numbing medication) will be injected at your surgical sites to minimize your immediate post-operative pain. You should take acetaminophen and an NSAID around-the-clock, according to instruction, for the first 72 hours and then as-needed thereafter. You can purchase these over-thecounter. You will be given a small number of low-dose narcotic pain medications for breakthrough pain only for the first 72 hours.  

  • Recovery Period – You are expected to go home the same day of surgery and should be ambulating without restriction the same day of surgery. Depending on your occupation, you may return to work as early as the following week. You may resume light cardio exercises at 2 weeks after surgery. You may resume all physical activities at 4 weeks after surgery. Your incisions will take 2-4 weeks to completely heal, but the final scar will take 6-12 months to mature. You should expect to be swollen and bruised at both the liposuction and fat grafting sites. Your breasts will look larger than what you and Dr. Chang discuss because of the swelling and because Dr. Chang injects additional fat to account for the fact that not all of the fat grafts survive.

  • Follow-Up Visits – If you have any urgent concerns, you may call the office at any time. Otherwise, expect follow-up visits at 1 week, 1 month, 3 months, 6 months, and 1 year. 
  • Dressings and Incision Care – Your incisions will be dressed with surgical bandage strips and/or surgical skin glue. You will be wearing a comfortable surgical bra stuffed with gauze pads. The bra should be snug but not overly tight. You should try to wear the surgical bra as much as possible but may remove to shower and to wash the bra. You may shower the day after surgery but cannot bathe or swim until instructed to do so.

Post-Operative

  • Unmet Expectations – Despite thorough pre-operative planning and discussions, you still may not be fully happy with your aesthetic results.

  • Asymmetry – No one’s breasts are perfectly symmetric. While the goal is near-perfect symmetry, there may be some asymmetries in breast size or position, nipple-areola complex size or position, and scars.  

  • Implant Rupture – Both saline and silicone implants can rupture. For saline implants, you will notice a relatively abrupt decrease in your breast size, and your body will absorb the saline naturally. For silicone implants, the silicone generally stays within the capsule of the implant but sometimes can spread outside.

  • Implant Malposition – The breast implants may move into an incorrect position, typically falling too low on the chest from gravity or too close to the middle or too far out on the sides.

  • Capsular Contracture – A capsule of your body’s tissue forms around the outside of the implant. Occasionally, this capsule can become very thickened and can be palpable, distort the implant, or cause pain.

  • Poor Scarring – Everyone scars differently. The final scar takes 6-12 months to mature. In rare cases, hypertrophic scars or keloids may form and may require secondary revision.

  • Infection – Infections are managed with antibiotics. In severe cases, you may need an additional procedure. 

  • Bleeding – Significant bleeding after surgery may require an urgent return to the operating room. Smaller collections of blood may be treated conservatively or managed with a small procedure in the office or the operative room.

  • Changes in Sensation – Temporary changes in breast and nipple-areola complex sensation are expected. Permanent changes may also occur, both decreased and increased sensation.


Complications

Trust in Expert Care for Beautiful Results – Contact Us to Learn More!

Request a consultation