Introduction Not many people know that nowadays plastic surgery offers a new, safe, and completely natural method to get bigger, rounder breasts. The procedure is called breast lipofilling or fat transfer to the breasts. As the name suggests, breast lipofilling entails adding volume to the breasts by using fat collected from areas of the body where there is an excess. The fat is harvested with liposuction, often from the midline or the thighs, purified and then reinjected into the breasts with the help of a special syringe. Fat transfer to the breasts is effective and safe for the patient. Moreover, there are limited risks and potential complications that can occur compared to breast implant surgery. However, this doesn’t mean that breast lipofilling is a substitute for implants. The results achieved with the procedure are very different. Implants allow for a better control of the final size and shape of the breasts. When using fat to augment the breasts, we can give just an estimation of the results that can be achieved. However, there are multiple factors that can affect the results of breast lipofilling. Here are just five of them: Smoking Smoking is more than a bad habit, and it is something that can significantly impact your health condition in more ways than one. When it comes to smoking and aesthetic surgery, an experienced plastic surgeon will tell you about the negative effects it can have. Delayed wound healing and fat or skin necrosis are complications often associated with patients who smoke. For patients who smoke, there is an increased risk of developing certain complications that could otherwise be avoided or are rarer to occur. When it comes to fat transfer, smoking can be a factor that can produce considerable damage after the procedure. You might wonder how smoking can interfere with the results of a breast lipofilling. Well, the answer is rather simple. When you smoke, there is less oxygen in the blood and generally speaking, smoking creates a vasoconstriction effect. This means that the blood vessels tend to constrict. So the development of a new blood network to feed the newly grafted fat cells is very difficult if the patient smokes after the procedure is performed. As a result, the survival rate of the fat cells transferred is much smaller in patients who are smokers. To avoid altering the results, patients are advised to stop smoking three to six weeks before the procedure and continue to remain non-smokers for the same amount of time post-op. This is crucial if you want to get good results. Make sure to discuss this issue with the plastic surgeon during the pre-operative consultation if you feel it will be hard for you to stop smoking. Sleeping on the tummy A factor that could cause significant damage to the blood cells transferred during breast lipofilling is intense pressure applied on the breasts. The plastic surgeon will talk to you about resting positions after breast lipofilling and mention that sleeping on the tummy is to be avoided for a minimum of three weeks post-op. This recommendation is made with the aim of helping the patient sustain the results and ensuring that a vast majority of the fat cells transferred will survive in the new environment. Intense pressure put on the breasts too soon after breast lipofilling will result in the death of the fat cells in the area and their reabsorption by the body. Also, you should be aware of the fact that when pressure is applied that causes the death of fat cells, asymmetries can result in terms of the shape and size of the breasts. This is something that we are trying to avoid after a breast lipofilling, especially because an additional procedure might be required to correct the results of the first one. If sleeping on the back is difficult for you, get plenty of pillows and arrange them on the bed in such a way that your breasts don’t end up supporting your whole body weight for a minimum of three weeks after breast lipofilling. Special post-op bra After any type of plastic surgery on the breasts, the plastic surgeon will ask you to wear a special post-op bra or a good quality sports bra. The compression bra needs to be worn non-stop during the beginning of the recovery period for about two to four weeks and after this for a few more weeks, just during the day. The plastic surgeon will give you more details about the brands to choose for a good quality bra and the right specifications. The bra needs to have a breathable material and the right level of compression and support. Also, make sure to get a bra in your size as otherwise the results might be compromised and your recovery period more uncomfortable. The recommendation is to have at least two bras so you can change them after each shower and always have a clean one ready. Patients who wear the special post-op bra according to the plastic surgeon’s recommendations have more chances of achieving satisfactory results after the procedure. Physical exercise Plastic surgery is not performed to cure an illness, so the patient doesn’t have to stay in bed for too long. However, at the same time, don’t expect to go from the operating room directly to the gym or to resume your daily activities like nothing happened because this won’t be the case either. What should happen after a breast lipofilling is for the patient to get off the bed as soon as possible after the procedure and take a few steps around the room. This should be done every couple of hours for a few minutes and the time spent walking should increase gradually. This recommendation is given with the aim of helping the patient avoid developing a complication that can be life-threatening called deep vein thrombosis. This condition is characterized by the formation of the blood clot that travels through the bloodstream and blocks a vein. Keeping active after any type of plastic surgery procedure, including breast lipofilling, is important. However, intense physical exercises can lead to unsatisfactory results as the fat cells might die. Strenuous physical exercises should be avoided for a minimum of four weeks to ensure the survival of the fat cells that were transferred to the breasts. It can take three to six weeks for a new blood network to develop that will ensure the survival of the fat cells grafted. After this happens, there is no danger anymore for the fat cells to be reabsorbed by the body, so physical exercises can be resumed. Make sure to discuss this issue with the plastic surgeon before getting back to the gym. Weight fluctuations One of the factors that cause the unsightly appearance of the breasts in the first place is weight fluctuations. Many plastic surgery procedures are performed exactly with the aim of correcting the imperfections left behind after patients suffer weight fluctuations. This is why it is essential to avoid gaining or losing weight after undergoing a fat transfer procedure. Three months after, the fat cells transferred will already begin to behave just like the cells that were initially in the breasts. This means that if weight loss occurs, the cells transferred will lose some volume and if weight gain happens, the fat cells might increase their volume. Conclusion The results of breast lipofilling can be influenced by multiple factors such as smoking, sleeping on the tummy, wearing the special post-op bra, weight fluctuations, and physical exercise. Aside from these factors that are important during the recovery period, the technique used for the fat extraction and fat injection is also essential and can affect the results. To make the most out of your breast lipofilling, choose a talented and experienced board-certified plastic surgeon to play out your procedure. It is also important to mention that the results can be long-term if the patient is dedicated to following the recommendations of the plastic surgeon and especially keeping a stable weight after the procedure.