Along with implant placement or breast lift, breast ptosis or atrophy can also be corrected using autologous fat transfer to fill lost tissue. It is particularly effective for mild to moderate breast ptosis because the problem is usually the loss of fat in the upper breasts. If patients are not interested in using implants to support their breasts, then the injection of autologous fat in the hollow parts of the upper breasts is the only way to fix the problem. Fat transfer not only locally adjusts the ptotic breast shape but also restores the firmness and elasticity of atrophic mammary glands and the skin. The injection amount must be carefully considered when using autologous fat in these cases because over-injection can potentially lead to breast burden that may have reverse effects of accelerating ptosis in the future. Based on Dr. Chuang’s experience, this surgery is ideal for patients with a breast size larger than B or C cup and for those who have mild breast ptosis or atrophy who can achieve 70%–80% correction. It is not recommended for patients with severe breast atrophy who have sagging skin or even dropping nipples.

Surgical conditions

Duration

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Type of anesthesia: General anesthesia or IV sedation
Type of incision: 0.3-cm pinhole incision in the medial or lateral lower breast
1-cm liposuction incision (belly button or groin)
Recovery: 2–3 days
Removal of stitches: 7 days

General instructions

No food and water on the day of surgery

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Stimulation with cold compress or excessive heat should be avoided for 2 weeks postoperatively.
Compression or aggressive massage of the breasts should be avoided for 1 month postoperatively.
Smoking and alcohol consumption should be avoided for 3 months postoperatively.
A supportive bra wear can help stabilize breast position.
Periodic follow-ups and check-ups are necessary if breast lumps are observed even after 6 months.

Ideal candidates

Those who are not willing to receive breast implants or lifts to fix breast ptosis.
Those who have natural breasts in good condition (B or larger cup size) but with mild atrophy or ptosis.
Those with mild to moderate atrophy due to pregnancy or breastfeeding.
Those who have less than grade 3 breast ptosis.

Possible complications

Excessive breast burden
Breast calcification
Unknown lumps
Autologous absorption
Mammary gland inflammation
Unsatisfactory results

Surgical advantages

Avoids risks of breast implant placement or scars from breast lift.
Texture of the breasts is the same as that of natural breasts.
Natural look with no trace of surgery.

Surgical drawbacks

Gravity may still cause ptotic breast after fat injection.
There is a problem with the self-absorption of fat; thus, the long-term effects still need to be verified.
Possible breast calcification or lumping.
Possible influence on breast physical examination or mammograms.
Contraindicated for those who have a family history of breast cancer or multiple cysts.