Am I Too Slim for a Breast Augmentation with Autologous Fat?

A patient asks regarding a breast augmentation with autologous fat:

We have heard about your excellent references for breast augmentation with autologous fat on the Internet. My friend and I recently had a consultation appointment in Cologne. The doctor there was of the opinion that my fat deposits are definitely insufficient. Is that right? Would it be possible to make a statement in advance, for example, based out on a photo or is it necessary to travel from Germany to Vienna?

Even prior to the actual personal consultation the patient can send photos by e-mail or arrange an informative appointment with webcam via Skype, before she has to undertake a quite long journey to Vienna. In fact we can almost always find enough fat, all the years we rarely had to reject patients because of too little fat. All we can say is that we are specialized in finding enough fat, even in women who have already been rejected as “too slim” by other doctors.

Prior to the surgery pre-stretching of very tight breast tissue can be recommendable, where appropriate. This can be achieved by using a mechanical suction bra (e.g., BRAVA system) or through injection of saline solution. This way the tissue will be loosened up and new space for the fat to be injected is created. Consequently, a more extensive augmentation can be achieved. But in fact most patients decide not to perform pre-stretching.

The actual procedure of breast augmentation with autologous fat starts with a liposuction with thin microcannulas.

Particularly in slim women it is important to choose a special method of liposuction: For the fat extraction we are using thin microcannulas, which have a diameter of only 1 to 2.5 millimeters. With these “fine tools” we can achieve much higher precision than in common liposuctions where regular cannulas are used. This is why we can obtain fat even from regions where liposuction normally is not performed. Tiny prick sites already disappear a few weeks after the procedure.

Obtaining body fat using liposuction will change the body shape on the areas where the fat gets harvested. The agreement, whether less fat is taken from many body regions or if the focus is only on shaping of “problem zones” is also a crucial point. This is the patient’s choice or rather prescribed by the body shape. In very slim women a small amount of fat has to be harvested from many different areas to reach the amount necessary for the breast augmentation.

After fat harvesting the fat can be enriched with autologous stem cells before it gets injected. By this enrichment with autologous stem cells the fat gets “more sustainable”. This allows for results which last in the long term and have to be refreshed only in very rare cases. Results may vary from patient to patient. Please note that in medicine generally no guarantee for a certain treatment result can be given.

Then the autologous fat is injected into the breast to reach the desired increase of volume. As a general rule an augmentation to an extent of about one cup size can be achieved. After healing of the post-operative swelling the breast appears naturally augmented. No matter if standing, sitting, or lying – the augmented breast looks natural and feels “real” as well.

The entire procedure takes place on an outpatient basis under local anesthesia, whereby the patient is spared the risks of general anesthesia. After 2 to 4 hours gently-performed manual work the patient can directly be discharged home and be pleased about her natural breast that is only augmented by her own tissue.

DDr. Heinrich, MD

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