Can I get my breast implants out and replace them with fat?

Most likely, YES. I’ve been doing this fat-transfer-to-the-breasts thing for over three years now and it really is the closest thing to a miracle that exists in plastic surgery. I’ve said it to all of my patients and I’ll say it again: If I hadn’t already had all my fat sucked out ten years ago I would totally have it done in a second. I know I’ve already blogged multiple times about it, but now I would like to address this specific question that everyone who wants to get rid of their breast implants asks me.

Let me start out by saying that I am absolutely all for breast implants. I still put a lot of them in and they’re great. They are. Most of the time. When everything’s good, they usually look better than real breasts of comparable size, because they give you that upper breast fullness that we start losing in our mid-twenties. You can get them done in a way that nobody will know, or in a way that everyone will know and show them off. You can go without wearing a bra. Men like them (see previous post, Do Men Like Breast Implants?) And they don’t sag like natural breast tissue does.  Women who come to see me for breast reductions can never understand why anyone would want to make their breasts bigger. It’s simple–DD breast implants defy gravity much better than real DD breasts that hang and pull, causing back and neck pain and bra-strap grooving and rashes.

But, as many of you out there know–and you’re probably the only ones still reading this blog–with breast implants, you’re never out of the woods. They move, they ripple, they (RARELY) rupture (rupture rate of the new Sientra implants recently reported at less than two percent, so that’s good.) They can be great for five years and then, for no reason you develop a capsular contracture (rates reported at anywhere from eight to thirteen percent for all gel implants). Or even worse, you could be one of the unlucky ones who gets a contracture from the beginning, and winds up getting one side removed and replaced three times in less than two years. Dr. Roger Khouri, one of the “fathers” of fat grafting to the breast calls those patients “Implant Cripples.” Sounds harsh, but he makes a point. For some women, they just never work.

So far, my patients and I have been extremely happy with the results with this procedure–removing breast implants from someone who’s “done” with them and re-augmenting with their own fat.

My goal with this particular blog is to help those of you who are genuinely investigating this procedure to understand how it’s being done. When patients ask me about it, they seem to have an image of me just taking out the implants and putting a big glob of fat in the space that’s left behind.

That’s not how it works.

I think that as surgeons, we make the mistake of assuming that our patients have a clear mental picture  of the anatomy of their surgery without explaining it to them, and then we’re confused when they don’t understand the limitations and mechanics of a certain procedure.

Just warning you, this is about to get somewhat dry and technical, but is extremely useful information for those of you who really need to know:

Whenever I am discussing a breast procedure with a new patient, I usually draw pictures like the ones below, which are diagrams of where  “under the muscle” (left)  and “over the muscle” (right) breast implants sit.

The white line around the implant is the “capsule.” This is your own normal scar tissue that has formed around the implant. If this scar tissue becomes thick, it squeezes on the implant, making it feel hard, and that’s a capsular contracture

When I am switching someone’s implants out for their own fat, after the lipo, I remove the implant through an inframammary (in the crease under your breast) incision. The fat is then placed not in the space where the implant was, but in tiny micro-tunnels in the layers of tissue between the capsule and the skin. This is one of the cases where we say that the “capsule is your friend” because it is keeping the fat from getting into the space where the implant used to be. And it’s okay to leave the capsule there. If we’re not putting a new implant in, and there’s not ruptured silicone all over the place, it doesn’t have to come out. It’s your own tissue and it will eventually reabsorb. A drain is placed in that space (those of you who’ve had multiple breast aug revisions are probably familiar with those) and the space closes down on its own.

How much fat can you get in there?

Depends on how much you have, and how thick the layer of tissue is that I’m putting it in. As you can imagine, it’s better for everyone if your implants are sub-muscular, because then there’s the added layer of muscle to put the fat into. Most of the time I can get enough fat in so that when I’m done, the breasts look almost as big as they did with the implants. In fact, most of my patients who have undergone this procedure laugh about how their friends say, “Are you sure she took them out?” (Obviously they haven’t explained the lipo part of it. :))

But won’t my breasts be saggy afterward?

They might. And you may elect to do a mastopexy (lift.) I personally prefer to wait to do the lift as a second surgery because the breasts get swollen when the fat is placed, and you can get a better lift if you wait till the swelling goes down.

So, for those of you who are considering this procedure, I hope that this blog helped you understand exactly what it’s all about.

Before I leave you–here’s an update on the “Paris Girl” that everyone always asks me about, two years out from her fat transfer to the breast, still wearing a C cup.

She has no scars, and her breasts look and feel so natural in fact, that when she had a little tryst with a member of a royal family over there in Europe…well, I guess you could call it, “The Prince and the Pea.” 🙂

XO

LQ

35 comments
  1. Penrose Anderson said:

    Marvelous blog. Fascinating. Why aren’t we all doing this? Hmmmm…. Something to truly consider. Thanks so much, Lipo Queen.

    Sent from my iPhone

  2. W Stephens said:

    Hi Lipo Queen!

    You mentioned that you had all your fat sucked out of you 10 years ago.

    Just out of interest, how much did you have sucked out and from where on your body?

    Did it gve you a bikini body?

    Has any of it returned?

    • Hello!
      Yes I did. It was from my inner and outer thighs (genetic saddlebags, just like my mother, ugghh!) that became noticeable to me in my late twenties. I’d been telling my plastic surgery attending (a woman) how much I needed it, but since I was thin everywhere else and it was easy to hide (plus, back then we were wearing those tight jeans that flared at the ankles, balancing everything) she kept saying, “No, you don’t, you’re crazy.” Then one day we were changing in the locker room for a case and she looked at me and said, “You’re right, you could use some lipo” and I was like, “YES PLEASE NOW!!!!” It was a relatively small amount (probably about five hundred cc from each inner/outer thigh, which is like one and a half cans of Coke) and I don’t think anyone noticed that I didn’t tell (but I was so excited about it I pretty much told everyone.) But I have to say, it was ABSOLUTELY LIFE CHANGING. I’ve never spent a lot of time in a bikini but yes, it did make me look better when I wore one. But more important to me was that my clothes fit so much better. I could wear skinny jeans and pencil skirts without feeling self-conscious. Even though I knew it wasn’t something that anyone else– especially a guy–would care about.

      No, it has not returned. It did a little bit when at first I was suddenly like, “Oh my God I’m so skinny!” and ate Jack in the Box combo meals for breakfast every day, but when I got back into a healthy lifestyle it went away and now it’s better than ever. There’s still not a day that goes by that I don’t think about how happy I am that I did it.

      Then, five years ago I had one of my colleagues try out my Smart Lipo machine on my muffin top area. Maybe it was a half a can of Coke worth. Again, hasn’t come back and so happy I did it. Fortunately, my husband has zero interest in this blog and has no idea that that was my SECOND liposuction, lol.

      That’s the truth. Straight up! Hope that was helpful!

      XO
      LQ

  3. T said:

    This sounds great!
    My question regards the procedure with someone who has never gotten implants at all. I developed very early – a full B cup by age 11, a C cup until 17 and then a D cup until after breastfeeding three children (twin and a singleton) for a year each, with minimum down time between. My breasts now fluctuate between a full B cup and a full C cup, depending on my weight, but they are saggy and my left breast, which was always slightly smaller, is now much smaller than my right and I have to wear a padded bra so that it is not noticeable through my shirts.

    I am very self-conscious about this and I do not like to take my bra off in front of my husband due to the major difference in size between my breasts. I am willing to place fat into the left breast or take fat front the right breast; as long as they are the same size I will be happy. Please advise the best way for me to proceed. I think I would prefer fat and a lift over implants due to the risks and other factors.

    Thanks so much!
    T

    • Hello T,

      I have done this exact procedure that you are describing. It does sound like you would need a lift or reduction on one side in addition to the fat grafting. I would be happy to see you in consultation to discuss your options. If you live far from the L.A. area, we can set up a phone consultation, for which you would email pictures ahead of time. You can reach my office at 310-275-3990 or email with a contact form from the website, drtrott.com.
      I look forward to meeting you!
      Best Regards,
      LQ

  4. Mary said:

    Hi,

    Love your blog. Thanks for sharing this great info.

    I had a bilateral mastectomy with implants last year. First, these implants hurt and I go to PT every week for and pain (I may be an implant cripple). I had a revision and scar removal in February and am worried the scar tissue nay be coming back. Plus, I’m very unhappy with my results. My breasts are not symmetrical, they are shaped like hamburger buns and are very small at a B-. I was supposed to get a full C. My questions are:

    Could I benefit from explant and fat transfer to improve the size and shape of my breasts?

    If so, would insurance cover it? I have Aetna in AZ.

    I’m really at my rope’s end with all the surgery, baggy bras and pain. My plastic surgeon is a nice guy, but he can’t understand why I’m dissatisfied.

    Thanks so much.

    • Hi Mary,
      Thanks for the support! I’m glad I’m getting some good, true information out there instead of just biased sales pitches. Sorry you are having a rough time. Breast reconstruction usually requires a few “tweaking” procedures to get it right, no matter how it’s done. First of all, it’s important that your surgeon understand what it is you don’t like, and that he address it as something that can be fixed or not, based on your body habitus, whether or not you’ve had radiation, etc. So if the two of you can’t get on the same page about it, I would suggest you get a second opinion. Secondly, it’s possible that you could have the implants removed and fat transferred but I would have to see pictures of you–both your breasts and the donor sites. If you went that route–complete implant removal and fat transfer–it would be multiple procedures (all outpatient, as long as you are healthy) that could take up to a year, maybe longer, since it couldn’t all be done at once. It sounds like for the result you desire, the best place to start would be just doing some fat transfer IN ADDITION to the implants (keeping them in place) and seeing how that looks, maybe even a couple of times. Then if you still really hate the implants, they could be removed at a second or third procedure. Other than that, your only other options would be a flap (like a latissimus or TRAM) which I’m sure he has already discussed with you, and that is a much bigger surgery, especially when bilateral. Unless you’ve been radiated on one side, you should be able to get a decent result with bilateral expander/implants. The capsular contracture (pain and scar tissue you are referring to) can be addressed as well with placement of an acellular dermis (cadaver skin like Alloderm or Flex HD). I don’t know if that was already placed but it doesn’t sound like it.
      Anyway, I hope this information helps. I would be happy to see you in consultation or with a phone consultation if you can’t make it to L.A. My patient coordinator can set it up. You can email her from my website drtrott.com or call the office 310-275-3990.
      And yes, your insurance should cover it as long as the physician will take it. There are procedure codes for fat grafting that I use all the time.
      XO
      LQ

  5. An said:

    Hi!!

    Very infornative blog!

    I realise I full consultation is best, however, I am wondering if removal of implants and replacements with fat transfer is possible. I currently have 500cc implants that were replaced 12 months ago after having PIP implants. I was advised at the time they would be the same size as my existing inplants, however, they are considerably larger and I am very unhappy. I also have considerable rippling. My surgeon advised removal and downsizing is not possible without considerable scars around the nipple. I am yet to seek a second opinion. I am wondering If removal, and replacement with fat transfer is possible in my my case?

    • Hi Andrea,
      Glad you’re finding the blog helpful! Removal of implants and replacement with fat is possible, but as you mentioned, each patient’s situation is different, and whether your results are satisfactory to you depends on your goals and the limitations of what the surgeon is starting with. The fat is not placed into the pocket where the implant was, but in microtunnels in the tissue between the old breast implant capsule and the skin–this includes the muscle layer if the implant was placed under the muscle originally. There are so many variables involved. From your description, since you have rippling, it sounds like you don’t have much breast tissue or body fat covering the implants. Depending on whether you have ptosis (nipples are pointing down) or the implants are just too big, you may not need a lift with external scars but just a capsulorrhaphy (internal stitches that downsize the pocket). Also, are your implants saline or silicone? If they are saline, if you are willing to have them deflated in the office, (just with a percutaneous needle) then you could allow the pockets to shrink down for a few months so that the capsulorrhaphy might be more effective. If you have rippling, the capsules are probably thin, and allowing them to shrink down some and thicken a little would help the success of the surgery.

      The reason I am mentioning all of the above is because from your description, it sounds like you are quite thin, and the tissue coverage over your implants is also thin, and the likelihood of you going from 500 cc implants to just fat and getting a satisfactory result is low, even though you want to go down to a smaller cup size. You would most likely need a combination of a smaller implant and fat transfer. However, I could be totally wrong–if you have good tissue thickness over your implants and good “donor sites” for the fat transfer then the fat alone may be enough.

      To give you any further advice I would really have to do a formal consultation with you. If you are not in the Los Angeles area a phone consultation can be arranged through my office staff. They can be reached at 310-275-3990

      Best Regards,
      LQ

  6. Natalie said:

    Thanks so much for this blog!!! I had saline implants for approx 10 years and had them replaced with silicone about five years ago. I never liked the notion of implants at all but i had a tuberous breast and I only recently found out about this option! I’ve never had any complications with any surgeries or healing – I would just rather my own fat if it’s possible.

    My question is around timing. I’ve heard different things about when the fat transfer should happen. One opinion is that it is best to have the fat transfer done at the same time as the explant. The other opinion is that it is best to wait (at least two weeks) after having the explant to have the fat transfer. Those who advocate the second method seem to think that it’s easier to remove the capsule if you wait and also that there’s less risk of getting fat into the “pocket.” What is your opinion?

    Also, I nursed two babies and would likely need a lift on one side at least (i have some asymmetry). I’ve heard some doctors do an “internal lift” using an “internal bra made of surgical suture material.” I’ve heard other doctors say that the internal lift is more “marketing” and not effective or even prone to infection. I’ve also heard terms like “tissue enhancement” and “fiber release” used to describe achieving a good result with fat grafting. I would love to know your opinion! Thanks in advance!

    Best,
    Nina

    • Hi Nina,

      Glad you are finding the blog helpful! I feel badly because I just haven’t had time to blog since it’s been such a crazy summer and I am actually leaving for Europe for two weeks today (my first real vacation in so loooong!) but I wanted to get back to you before I leave.

      Funny–I just did a periareolar (around the nipple) breast lift with implants for a girl with severely tuberous breasts two days ago. After all of my experience with implants and tuberous breasts over the last ten years, and then fat grafting for the last four years, I would say that implants are still the way to go for primary tuberous breast deformity. At least initially. With the experience that I have had, I don’t one hundred percent believe the pictures I am seeing where surgeons are showing before and after reconstruction of tuberous breasts with one session of fat grafting. You would HAVE to wear the BRAVA before hand which is basically incompatible with normal daily living for anyone who works outside their home or has to take care of kids–go to drop-off, after school activities, etc. And even with the BRAVA, I think you would need at least a couple of sessions, spread three months apart to get the results that those guys like Dr. Dan Delvecchio is showing. However, this is based on my experience, and my patient population that is really unable to wear the BRAVA religiously. He may be dealing with women who wear it 24/7 for a month before and this may make a difference. It is very difficult to release that tight lower pole of breast tissue with fat grafting alone. I have watched Dr. Khouri do it myself for hours (you have to do it with hundreds of little needle pokes that he calls “Rigottomies”–this is the “fiber release” you are talking about–which work, but not as well as going inside and releasing it like you can when you put in an implant.) Also, if you look closely at the pictures, most of those patients have periareolar mastopexies in conjunction with the fat grafting. So while fat grafting to the breast is turning out to be the most AMAZING procedure ever (I think :)) you haven’t missed out on anything.

      However, I think you can enhance the tuberous breast reconstruction result tremendously with fat transfer to round it out even more, and I have done this. This is the “tissue enhancement” you are describing, and something you can do any time.

      As far as removing your implants and replacing them with fat, your satisfaction with the result is going to depend on a few things. First of all, how big are the implants and how big do you want your cup size to remain? Because most likely you are not going to get the same volume with the fat with one session unless your implants are very small (which they probably aren’t since they were placed to fix a tuberous breast deformity.) Secondly, you have to have the donor sites. That is something I could only tell in a consultation with you. But I can tell you that it is UNLIKELY that if you like the way your implants look, you are going to be happy with just replacement with fat.

      As far as timing, I do the removal and fat injectin at the same time. When you are removing implants and not replacing them, it is unnecessary to remove the capsules (unless they are so hard and contracted that you can feel them from the outside.) The point is to KEEP THE CAPSULES in, because they are the barrier that keeps the fat from going into the implant pocket. But again, these are women are sick of their implants and just want them out, and figure putting fat in is better than nothing.

      “Internal lift” is definitely a marketing term. A breast pocket can be closed down internally if someone doesn’t need a lift, but wants to go with a smaller implant, but that’s not a lift, that’s a capsulorrhaphy. You cannot raise the nipple internally reliably without external incisions unless a bigger implant is placed to fill out the lower half of the breast and raises it up. “Suture material”…There is a mesh that is used for this that I’ve seen presented at conferences by plastic surgeons from Brazil but the procedure is pretty invasive and I do agree that there is a higher risk of infection, and I’ve seen a patient who had that done and said it was awful–that it was very hard, she could feel the mesh, and she had to have it removed. I might try it on a really enormous breast reduction where the benefit might outweigh the risk, but probably not on a cosmetic patient.

      I hope this has been helpful. Let me know if you have any other questions! Happy Sunday!

      XO
      LQ

  7. Nancy M. said:

    Thank you so much! This is exactly the information I’ve been looking for. My implants are about 10 yrs old, saline, 250 cc, and have grade 4 and grade 3 contracture. I have always felt they were too big for my frame and wish they were significantly smaller. I’d truly be happy with a full A cup with good symmetry. If fat transfer had been possible 10 years ago, I definitely would have gone that path. Does the contracture require capsulectomy or would you still consider leaving them? (I understand a consultation would be the only way to say for sure.) Also, what is the recovery time for implant removal and fat transfer?

    • Hi Nancy,
      If you have the donor sites, it sounds like you would be a great candidate for the procedure. Ideally, when I’m doing this procedure I like to leave the capsules in–this keeps the fat in the tissue and stops it from going into the pocket where the implant was. This is the technique that I learned from Dr. Khouri in Miami. However, I have had a situation where I had to go back and remove the capsule because it was so firm and thick that you could still feel it through the skin, even with the implant gone. Avoiding capsulectomy also considerably decreases healing time–the drains are usually only in for a couple of days, and depending on how many donor sites are needed and how extensive the liposuction is, the recovery can be anywhere from a few days to two weeks in terms of time off work.
      Hope this is helpful!
      XO
      LQ

  8. remia white said:

    I want to get a tummy tuck I was wondering is it possible to insert the fat that they’re taking out and putting it into my breast

    • Hi Remia,
      There is usually a component of the tummy tuck that involves liposuction, usually of the sides. Also, when I do a tummy tuck, I usually do a liposuction of the lower back. So yes, your surgeon should be able to use some of that fat for a natural breast augmentation.
      XO
      LQ

  9. helene said:

    Hi LQ,
    I had a BA 3 years ago. Had mild-moderate tuberosity, and got 250cc gel implants above the muscle done. I didn’t even fill an A cup before, and after was a B cup, but with still puffy areolas. A year later got a capsular contracture, re-did the surgery to remove the capsular in my left, and the PS also removed my natural fat behind my areolas to make them more flush on my skin. Another year later, I got a capsular contracture in my right, its been there since, all the while me trying to massage it, which hasn’t helped. Over this time, I now feel it starting in my right again. I am obviously very unlucky with implants so just want them out. Seeing as my natural fat was removed, I definitely would want fat grafting, and definitely have the fat on my stomach to offer (I’m 5’6, 130lbs, but all my fat goes straight to my stomach) I guess my questions are, with my frame, I think a B cup is too small, and would like to be a C cup. Is going BIGGER an option with fat graphing, if my implants were placed above the muscle? What are the chances my body will absorb more fat cells, causing them to shrink after? Also, my incisions were done around the areolas, can they still be done there, so I don’t have any new scars? I find my breasts are far apart, without roundness on the insides, can the shape be changed? Also, in terms of scarring, I’m left with white circle line around my areolas, any idea why they don’t match my skin tone, and are all these scar creams, or silicone sheets worth trying, have you seen improvement in your experience? Sorry for all the questions, its just been a very long and frustrating road, thinking of going on my 3rd operation in 3 years is not at all what I thought this experience was going to be.
    Thank you!!

    • Hello Helene,

      Dealing with both tuberous breasts and capsular contracture can be challenging, and it sounds like you have been going through a lot just to get something that looks “normal.” Fortunately, it sounds like there are still back-up plans left for you. As I understand it, you currently have subglandular implants (on top of the muscle) and recurrent contracture. These are your options–in my opinion, of course. Also, this is taking into account that you want approximately a C cup breast:

      1)Have your implants removed and replaced under the muscle with addition of an acellular dermis like Strattice, which has been shown to decrease capsular contracture. It is part of our arsenal against recurrent capsular contracture. This procedure can be done with or without additional fat grafting at the time.

      2) If you want to replace your implants with fat only, it may be possible to get to a C cup, but this will most likely take several fat-grafting procedures spread apart by three months each, and you may feel that your breasts are disproportionately small for a long time.

      3) Probably the best way to have the implants removed and replaced with fat would be staged procedures like in option 2, but have tissue expanders placed at the first operation, filled to what you have now, and over time slowly decrease them with each fat transfer so that at the third fat grafting session they can be removed. Tissue expanders are a little more expensive than implants–this is what we use in breast reconstruction.

      If you are going to have the implants replaced the periareolar (around the nipple) scars can be used, but I would not recommend using them if you are just taking them out, as the scar tends to pucker against the chest wall. I usually remove implants through small incisions at the inframammary crease.

      As far as the scars around your nipples, the white line is a mature scar that probably will not change. One thing that can be done is to have them tattooed a color to match your areolas or skin by a permanent makeup artist. They can also be revised if you have another procedure.

      Hope this is helpful. If you have any further questions, I would be happy to do a phone consultation with you through my office (drtrott.com)

      LQ

  10. Thank you for this information. I have a few questions. Will the fat that is put in place of the implant be reabsorbed by the body eventually? What if you lose weight (not significant but perhaps 10-20 lbs) – will you also lose the grafted fat in the breast area? Do you recommend that you are in your best shape before the surgery in order to prevent that? I would love to do this procedure after I finish nursing my 2nd (and last) baby. Thank you in advance!

    • Hope this is helpful:

      1) While some of the fat is absorbed, a percentage of it does seem to stay permanently. Reports of volume retention are up to 80% of what is placed in the breasts.

      2) When you lose weight, you don’t lose fat cells–they just shrink. So yes, if you lose weight after this procedure your breasts will get smaller because the transferred fat cells will shrink. But they’ll still be there if you gain weight again, so the volume is not necessarily lost for good.

      3) If you are at your ideal weight prior to the procedure, when the fat cells are smaller, a larger number of fat cells will be suctioned (think fitting grapes versus oranges in a tube–you can fit a lot more grapes than oranges ;)) and therefore a larger number of fat cells (though smaller) will fit in your breasts. So yes, it is ideal to be in good shape before the procedure. At least, this is what Dr. Roger Khouri explained to me while I was training with him, and it makes sense.

      Congrats on your baby and good luck! 🙂

      XO
      LQ

  11. Michelle said:

    I need more information. (Along with your information) I was told by another dr. That I could not have the fat transfer to breast because I have implants. I really want both For a more natural look and feel. I ould love to discuss the ppossibilities 🙂

    • Hi Michelle,
      If you have the donor sites for autologous fat transfer, you can have it along with implants. In fact, we often use it to camouflage rippling of breast implants in patients who have had mastectomies.
      I would be happy to see you in consultation to discuss your specific situation further. You can contact my office manager at silhouettecosmeticcenter@yahoo.com or through my website drtrott.com
      I look forward to meeting you!
      Best Regards,
      Suzanne Trott, MD, FACS

  12. Thanks you for the information. I currently have cohesive gel implants (was in a clinical trial) 12 years old. They are ~290cc. I was an A cup before and now a C. I hate the implants. I don’t want any type of replacement but if I can’t have fat transfer, I’d do silicon I suppose. The doc I’m talking to said he would inject ~350cc in each breast of fat understanding that they will get smaller (smaller is ok with me – large B would be fine). I’m also ok with the natural progression of sagging, etc. of that would happen vs. the “perky 20 yr old breast”. Is this a good option for me??

    • Hi Beth,

      It sounds like you could be a great candidate for the AFT procedure with simultaneous removal of your implants, but to advise you to move forward with it I would really have to see you in consultation (if not in person, via phone or Skype) and truly understand what your expectations are, by talking with you, examining you (or your pictures) and showing you pictures of previous patients. You also need to make sure that the “donor sites” on your body are respected. They need to be aesthetically contoured. Don’t let someone just go for the amount of fat they need in places that are going to leave dents.
      If you would like to schedule a consultation, my contact information is at drtrott.com.

      On another note–I am curious–when you say you had the “cohesive gel implants” do you mean the form stable, teardrop shaped ones? And if you hate them, I was wondering why? I don’t have many patients ask for those so I’m curious.

      Best Regards,

      Suzanne A. Trott, MD, FACS

  13. Beth said:

    Thanks for the reply. When I originally opted for them I wanted something that I knew I wouldn’t damage (I am very active and worried about damaging them), saline was my only option and those are NOT FOR ME (totally felt unnatural). I had very little breast tissue to begin with. They’d probably be great for a total reconstruction. Mine were fine in the beginning but they are just more firm than a 44 year old should have. Know what I mean? Breasts naturally sag, etc. and I think they are too big now too. Though I’m relatively fit, the implants are not natural and are beginning to look so. In the beginning and even now, most people question whether I have implants or not. They look absolutely great – standing up. But laying down, you can imagine, they don’t move much. At any rate, I’ve had several consultations with surgeons about the fat transfer and I’m totally comfortable with the surgeon. He is very good and I trust him. We’ve extensively discussed the donor sites and how important it is for me to look natural. . Let me know if you have other questions about the cohesive gel. Thanks for the advice!

  14. Dyan said:

    What is the cost to remove inplants and replace with body fat

    • Hi Dyan,
      Thanks for writing in. The cost of removing the implants and replacing the volume with body fat transfer varies, as it depends on how long it will take to harvest the fat. If you have an easy location to get it from, like your abdomen, it will be the least expensive–roughly around $10,000 and go up from there. However, I am a double board-certified plastic surgeon and I work at an accredited facility in Beverly Hills so the prices here are probably higher than other parts of the country.
      Hope that was helpful!
      XO
      LQ

      • Ileana said:

        Thanks but my question wasnt for the price I like to know if I remove my implants and transfer fat to the breast at the same surgery ?

      • Yes you can do it at the same surgery

  15. Ileana said:

    I neee to kknow if I have to wait when remove the implants to make the fat fransfer…some doctors say that I have to wait because if they remove implants and make fat transfer to the breast at the same surgery I can have an infection …is this true?

    • Hi Ileana,
      Thanks for writing in. No, you do not have to wait to have fat transfer at the time of breast implant removal. There is absolutely no reason for that. I do it all the time. In fact, I encourage women who are just taking their implants out to put at least some fat in.
      Hope that was helpful!
      XO
      LQ

  16. Nancy Frayer said:

    I had 20 year old implants removed 1 year ago because of rupture…Had them replaced. ….Then got a severe infection that almost took my life…..My new surgeon. …said he had never in all his career seen the bacteria and infection that he saw 6 weeks after the new inplants were put in….When he had to do an emergency surgery on me because the implants were falling out of my body….I was in debilitating pain for almost a year…..And now almost 1 year later I still have a little pain and discomfort….My left is completely gone…… and my right is some what there.about 85%nanlee06061943@gmail.com …And I have a lot of scar tissue in my right breast that had most of the infection… Not sure what I can do now…..I’m 72 years old…But STILL CARE very much about how I look…..It’s so depressing. ….Fat transfer would be the only thing I would EVER CONSIDER
    BUT DON’T think I’m a good candidate for it…..And I need the scar tissue out….because it is painful at times…
    PLEASE DO U HAVE ANY ADVICE FOR ME…OR COULD U HELP ME…

    • Nancy,
      I’m sorry you’ve had to go through so much–that sounds like a really scary infection. Have you talked to your plastic surgeon about doing something? I really wouldn’t be able to give you any recommendations unless I could do a consult with you either in person or over the phone. If you are interested, you can contact my office through my website either by phone or email at drtrott.com
      I hope I can help you!

      XO
      LQ

  17. Katie totres said:

    I gained 135lbs after getting a infected gallbladder put and have never been able to lose it and I always had large breast I have lost some of my breast lately because of weight loss after finding out that my thyroid wasn’t functioning how much would I need to
    Transfer to get my triple d back

    • Hi Katie,

      As you know, cup sizes vary between brands. It sounds like fat transfer to the breast could be a great option for you, however it also sounds like to achieve the results you want it would take multiple staged procedures. At least two, but I would really have to see you in consultation to give you the best advice. If you would like to set up a consultation, please contact my office at silhouettecosmeticcenter@yahoo.com or by phone 310-275-3990.
      Thanks for writing in and hope to meet you sometime!

      XO
      LQ

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