IntroductionWomen from all over the world are enjoying the benefits of being able to get the breasts of their dreams with the help of plastic surgery. Plastic surgery to enhance the breasts has been performed for over half a century now, mostly via implants. Now we are using the fifth generation of breast implants that deemed safe by the FDA and in no way associated with the occurrence and development of breast cancer, as demonstrated by multiple studies over several decades. Reports of plastic surgery associations from all over the world show that breast implant surgery is without a doubt in the top 3 most performed plastic surgery procedures. However, there is another procedure performed with the aim of breast augmentation that is gaining more and more popularity with each year. The procedure is called breast lipofilling but is also known under the names of fat transfer or fat grafting to the breasts.In this article, we will discuss how efficient the procedure is and how it is performed. Breast lipofilling: An overviewBreast lipofilling is one of the multiple procedures developed and performed with the aim of using fat from areas where it is in excess and transferring it to areas that could use more volume. For many women, getting rid of the fat from the tummy and adding it to the breasts is like a dream come true. Many women envisage the transfer of fat from areas where it is not wanted to areas that could use a boost of volume, and the breasts are often in this category. For patients interested in getting more volume in their breasts in a natural manner, the first step is to schedule a meeting with the plastic surgeon. This pre-operative consultation allows the plastic surgeon to perform a medical examination on you and also ask about your reasons and motivations to resort to plastic surgery. But it also gives you an opportunity to ask all the details of the procedure and the surgical plan and what you have to do to prepare for it. During the initial meeting with the plastic surgeon, you will also be asked about your medical history and whether you are planning to get pregnant in the future. There will also be questions about your weight and how happy you are with it and related to the medications you take. Don’t be surprised if the plastic surgeon will also ask you if you are a smoker. These questions have a very clear purpose, and this is to help the plastic surgeon make the best recommendations for your particular case. Generally speaking, the recommendation is to postpone breast lipofilling until you are close to your normal weight and the weight has been stable for a minimum of eight weeks. Moreover, an ulterior pregnancy and the changes that occur in the breasts during this time can alter the results, so again, the plastic surgeon might advise you not to schedule the procedure now if you plan to have more children in the future. The only risk of getting pregnant after the procedure is related to the alteration of the aesthetic results; otherwise, there are no risks for the mother or the baby, and the procedure doesn’t interfere with breastfeeding. Patients who smoke are advised to stop at least three to six weeks before the surgery. If they can’t stop smoking or at least lower the nicotine intake, the recommendation is to postpone the procedure. The lack of proper oxygenation in the blood that can occur as a result of smoking can interfere with the healing process after the fat cells are grafted in the breasts and can cause the death of the fat cells. There are other recommendations to be followed before undergoing a breast lipofilling, but they are the same as in the case of any other surgical procedure.Breast lipofilling is often performed with the patient under general anesthesia. This type of anesthesia is preferred both by patients and plastic surgeons as it is more comfortable for the patient. If you have been confronted with allergic reactions to anesthesia before, make sure to let your plastic surgeon and anesthetist know before scheduling your procedure.Breast lipofilling will start with incisions made on the abdomen or the flanks or the areas that will be treated with liposuction to get the necessary amount of fat for the transfer. There is a limited amount of fat that can be extracted safely during one session of liposuction, and this is about six to seven liters of fat, depending on the physical characteristics of the patient. After the fat is collected, it goes through a purification process that will eliminate the damaged fat cells, as well as the other impurities and blood. Once the fat is purified, it can be used for transfer to the breasts. The grafting of the fat cells to the breasts is performed with a special syringe. Once again, small incisions are performed, this time on the breasts to be able to insert the fat cells. When the plastic surgeon considers that there is enough fat transferred and the breasts are symmetric, the procedure is considered completed. Keep in mind that injecting too much fat into the breasts in one session of breast lipofilling can result in the formation of granulomas or the death of fat cells transferred. This is the reason why it is crucial to get a board-certified, experienced and talented plastic surgeon to play out your procedure to ensure you get the best results possible. How efficient is the procedure?When being recommended by the plastic surgeon to undergo a breast lipofilling, many patients want to know how efficient the procedure is. There are different myths going around about fat transfer, and most patients believe that the results will only last a limited period of time or there will be no visible results.Before anything else, we need to mention that the results achieved with breast lipofilling are not comparable with breast implant surgery. The augmentation achieved with breast lipofilling is more modest and the shape of the breasts is a natural one, following the contours of the breasts the patient had before the procedure. What actually happens when breast lipofilling is performed is that the breasts look fuller and a bit perkier. However, you won’t get from an A cup to a D cup in one session of breast lipofilling, and this is only possible with implants. The increase in the size of the breasts following a breast lipofilling is of about half a bra cup to a full bra cup but not more. Also, we need to mention the fact that in the first two months after the procedure the breasts are bigger, but a certain percentage (about 30 and even up to 40%) of the fat transferred is reabsorbed by the body during this first few months. This is completely natural and the plastic surgeon will inject more fat than necessary exactly because of this. Keep in mind that the results achieved with fat transfer can be sustained for long and even permanently only if the patient is dedicated to avoiding weight fluctuations and an ulterior pregnancy. The procedure is efficient and provides amazing results for patients who follow the post-operative recommendations of the plastic surgeon, don’t smoke, and don’t sleep on the tummy for a minimum of three weeks post-op. ConclusionWhile breast implant surgery is among the most performed procedures worldwide, there is no denying the fact that breast lipofilling is gaining popularity as being the only natural method to increase the size of the breasts. Patients prefer this procedure when they are confronted with adipose tissue in other areas of the body and when they desire a moderate and discreet augmentation with the breasts while keeping their natural shape. The results achieved with breast lipofilling are sustainable as long as the patient is dedicated to avoiding gaining or losing weight as this might alter the aesthetic results. Breast lipofilling is efficient and delivers satisfactory results to patients who understand exactly what it entails, how it is performed, and what results are to be expected. Keep in mind that the results achieved with breast lipofilling are not comparable with the results of a breast implant surgery.