Breast augmentation with fat transfer is one of the most common and popular plastic surgery procedures in the United States. Every year, hundreds of thousands of women undergo surgery to enhance their breasts. If your breasts lack projection and shape, you may consider fat transfer to the breasts. The procedure uses your body fat to enhance your breasts. Many people are not aware of how the surgery is performed. If you are considering the intervention, you should discuss the steps of the surgery with the plastic surgeon during the pre-operative consultation. During the surgery, the excess fat is removed from different areas of the body and injected into the breasts, which helps make the breasts shapelier and projected. How is the surgery performed? The breast augmentation with fat transfer involves the following steps: – Anesthesia administration – Fat extraction – Fat processing and purification – Fat grafting – Anesthesia administration The procedure starts with the administration of anesthesia. The surgery can be performed under general anesthesia or IV sedation. Most surgeons prefer to use general anesthesia. The use of anesthesia is important because the surgery involves incisions on the fat donor sites. A board-certified anesthesiologist administers the anesthesia. He or she will also monitor your health under anesthesia and manage your airway during the operation. If general anesthesia is used, the patient will be fully asleep during the surgery. The patient will not be able to make movements and remember the surgery. Also, the patient will not feel any pain and discomfort. Fat extraction/liposuction The surgery starts with fat extraction. Liposuction is used to remove the excess fat from the fat donor sites. The common fat donor sites include the abdomen, sides, flanks, upper back, and thighs. To qualify for the surgery, you must have excess fat in your body. Liposuction involves tiny incisions on the fat donor sites. After making the incision, the surgeon will insert a hollow tube called a liposuction cannula inside the fat donor area. The cannula is moved back and forth to dislodge the fat cells from the surrounding tissues. During the process, a tumescent solution will also be introduced in the fat donor site. It controls the bleeding and helps release the fat cells. A suction pump is then attached to the cannula and the fat is removed. The incision is then sutured and closed. The same process is repeated on all of the fat donor sites. The fat extraction process has to be carried out very carefully, ensuring that most of the fat cells are removed unimpaired and are fully healthy and alive. How much fat will be removed from the fat donor sites depends on your aesthetic goals and the aesthetic flaws in your breasts. However, there is a limit to the maximum amount of fat that can be removed from the body during one session of liposuction. Fat processing and purification After removing and collecting the required volume of fat from the fat donor areas, the plastic surgeon will process and purify the fat. The fat will be treated in a centrifuge at high speed. During this step, the impurities, dead, damaged fat cells, fluids, and blood are separated and removed from the healthy and living fat cells. The plastic surgeon has to make sure that only the best quality, fully healthy and living fat cells are collected for transfer to the breasts. Fat grafting Fat grafting is yet another crucial step of the breast augmentation via fat transfer. During this step, the fat cells picked during the fat processing are carefully injected into the breasts. The surgeon will use a special needle to implement this step. The fat cells are delicate, and the doctor will carefully pick and inject them into the breasts. The fat grafting process is lengthy and calls for attention to detail. The surgeon will count on his sense of aesthetics, artistry and surgical skills to properly execute this step. The doctor has to make sure the patient’s desired results are achieved in the best way possible. The surgeon will carefully sculpt and shape your breasts by injecting the fat cells in the places that need contouring. If the surgeon is inexperienced or not board-certified, he may not properly inject the fat cells into the breasts. It is important that you should choose only a highly experienced, board-certified plastic surgeon to perform the breast augmentation surgery. Results The results of breast augmentation with fat transfer will not be visible immediately after the surgery. Many patients think their breasts will become immediately projected, fuller, and shapelier right after the surgery. The fact is that once the fat cells have been injected into the breasts, it would take several weeks and even months for the final results to transpire. After the fat cells are injected into the breasts, your body will vascularize the fat cells. In other words, it means your body will establish blood flow to the fat cells, which will help them nurture and grow. The vascularization process normally starts within the first three weeks following the surgery. The final results will show after several months. When the ultimate improvements happen, your breasts will become shapelier, projected, sexy, and fuller. As a result of these improvements, you will experience a boost in your self-esteem. The patient must be extremely careful during the recovery period so the desired outcomes can be achieved safely. The best thing about this surgery is that since liposuction is performed on the fat donor sites, you can expect these areas to become contoured. After the surgery, the fat donor sites will become shapelier, smoother, youthful, and aesthetically appealing. Recovery The recovery period is also a major part of the surgery. Your recovery will start immediately after the breast augmentation with fat transfer. You must be very careful during recovery and follow the surgeon’s instructions. The primary recovery period comprises the first two weeks after the surgery, whereas complete recovery takes six weeks. During the first two weeks following the surgery, you must avoid sleeping on your front side because there is a risk the pressure applied to the breasts will not only damage the fat grafts but also trigger wound dehiscence and bleeding, which can lead to slow healing, infection, and abnormal scarring. Also, the patient must avoid physical activities that can apply pressure to the breasts. Strenuous activities like exercise, weight lifting, stretching, jumping, and bending must be avoided for six weeks after the surgery. These activities can trigger many complications. You will also be required to wear support bras for many weeks and even months after the intervention. Be sure to wear the support bras for the required period. The patient must follow the surgeon’s instructions to the letter as they are the keys to the achievement of your aesthetic goals. As for the fat donor sites, do not expose them to direct sunlight and any other form of direct heat for six months. Direct sun and heat exposure can trigger poor and abnormal scarring. Risks Like all other surgical interventions, the breast augmentation via fat transfer is a major procedure and entails many risks and complications. While the surgery is relatively safer because it involves the use of your own body fat instead of foreign objects like implants, it is not risk-free. The procedure is invasive and involves incisions. As such, your body will be exposed to possible infections for several weeks after the surgery. Be sure to keep the incisions clean and don’t touch them. Also, take your medications on time and according to the instructions of the doctor. There is also a risk your body may absorb some portion of the fat injected into the breasts. If this happens, you may require touch-up fat injections. Pressure applied to the breasts during the recovery period can also kill or damage the fat cells injected into the breasts. Other risks associated with the surgery include seroma, hematoma, change in or loss of skin sensation at the fat donor site, general dissatisfaction with the results of the surgery, risks of anesthesia, abnormal scarring, and the development of breast asymmetry if the surgery has not been properly performed. Conclusion Breast augmentation with fat transfer is a major intervention. It is used to add projection, shape, and volume to the breasts. The procedure starts with extraction of fat from the fat donor sites via liposuction. The fat is then processed and injected into the breasts. The results of the surgery will emerge after several weeks and even months. The patient must be very careful during the recovery period. There are also other risks associated with the surgery that have been discussed above.