Dallas Fat Transfer Breast Augmentation- Dr. John Burns MD

In the last decade, there's been a noticeable shift in the realm of cosmetic surgery and breast aesthetics – a move away from larger, overly augmented breasts to a preference for a more natural look. Many women today are leaning towards a modest, one to two-cup size increase that enhances their figure without appearing overly enhanced or "done."

Fat grafting requires both skill and experience with the technique. Published graft retention rates ranges from 50 - 90% fat graft survival.  Experience and skill are variables you will want to consider when making your choice for plastic surgeon.

Dr. John Burns, Jr., MD has performed thousands of fat grafting breast augmentations for women throughout the United States and the world, and is world-renowned for his advanced techniques yielding higher retention rates of fat in natural breast augmentation with fat.

Fat Transfer Breast Augmentation
Dallas Fat Transfer Breast Augmentation- Dr. John Burns MD

Enhance Your Breasts Without Breast Implants

In the last decade, there's been a noticeable shift in the realm of cosmetic surgery and breast aesthetics – a move away from larger, overly augmented breasts to a preference for a more natural look. Many women today are leaning towards a modest, one to two-cup size increase that enhances their figure without appearing overly enhanced or "done."

Another significant trend involves steering clear of traditional implants for breast augmentation. More and more women are choosing to forego the introduction of a medical device such as a breast implant and are instead opting for a more natural approach using their own fat. Fat transfer breast augmentation addresses a woman's concerns associated with implants and provides a solution that feels authentic and personalized.

What's particularly appealing to some women is the dual benefit of this approach in that it yields a "two for one" result. Through fat transfer, not only can breasts be subtly enhanced, but problem areas such as the abdomen or thighs can also be contoured. This proves especially beneficial for mothers dealing with post-pregnancy concerns like deflated breast tissue and trouble areas of stubborn fat.

One of the standout advantages of fat transfer breast augmentation is its ability to eliminate the need for subsequent surgeries. Unlike implants, which aren't permanent and typically require removal and replacement every decade, fat transfer offers a more enduring solution. While the process of removing and replacing implants is relatively minor, it involves surgery and the associated inconveniences that come with it. Choosing fat transfer provides a natural, long-lasting alternative without the periodic commitment to additional procedures.

What is Fat Transfer Breast Augmentation?

Fat transfer, sometimes referred to as natural breast augmentation, is a surgical procedure where fat is harvested from unwanted areas, processed to remove impurities, and then strategically placed back into the breasts to enhance areas like the upper and lower poles and cleavage.

Liposuction is carefully performed to remove unwanted fat from areas like the abdomen, axilla (armpit area), back (bra fat), flanks (love handles), thighs, arms, or neck. This breast enhancement procedure makes for a highly sought-after solution for women who desire to avoid traditional breast augmentation.

Gentle Liposuction

For liposuction, a tumescent technique is used where fluid is injected into stubborn fat deposits and then gently suctioned out along with the fat. The tumescent fluid contains sterile IV saline, pain medication (lidocaine), and epinephrine (adrenaline). The tumescent fluid helps to loosen the fat making it easier to remove smoothly while numbing the area, and decreases bruising through the effects of lidocaine and epinephrine respectively. Ideally, the amount of tumescent fluid injected should equal the amount of fat removed in a 1:1 ratio in what board-certified plastic surgeons refer to as the “super wet” technique.

Because fat tissue has a thicker consistency, it responds to gravity more than implants. Fat will collect in areas where there is breast tissue making it difficult to achieve a lot of upper pole fullness or cleavage. Fat tends to augment the natural breast which is tear-drop shaped. Additionally, only about one cup size increase is possible with fat transfer. This makes the procedure limited in terms of the amount of increase possible in a single session but also why many women prefer its more natural look.

Fat transfer is very popular with moms after pregnancy and breastfeeding. These cases are very amenable to fat transfer because their bodies typically have adequate donor sites after pregnancy and the breast skin is more loose, making it capable of holding more fat.

Fat Grafting Before and After- Dallas, Texas- Dr. John Burns Jr., MD

fat grafting to the breasts- Dallas, Texas- Dr John Burns MD
fat grafting to the breasts- Dallas, Texas- Dr John Burns MD
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How Is The Fat Purified For Fat Grafting To The Breasts?

There are multiple systems designed to purify fat in preparation for fat grafting. For small fat transfer procedures such as “touch-ups” or facial fat grafting, a centrifuge is used to purify fat in small amounts. However, these methods are not adequate for larger transfers as required for breasts or the buttocks.

There are multiple commercially available systems such as the Revolve system from Allergan or the Viality system from Sientra. These systems are excellent and deliver highly purified fat in larger amounts. Dr. Burns uses these systems in appropriate cases when indicated.

The gravitational filtration system from Wells Johnson is Dr. Burns’ preferred method. This is a “closed” system where fat is liposuctioned into a closed container. The container rests on a vibrating platform. The vibration and gravity separate the fat from the tumescent fluid and body fluids. Pure fat rises to the top of the cylinder and the fluid is removed by aspiration from the bottom. This pure fat is then washed, treated with an antibiotic solution, and then “reverse liposuctioned” or strategically placed back into the breast tissue using a cannula.

Dr. Burns prefers the Wells Johnson filtration system because the most reliable in processing the fat to the most ideal consistency for the smooth placement of fat. The method is also extremely efficient, drastically reducing the amount of time the fat is processed outside of the body while reducing the risk of wasting fat for re-injection in fat transfer breast augmentation.

Overly concentrated fat produced from some systems has higher metabolic demands and can result in more fat necrosis or hardening of the fat graft. These systems can also waste fat during the purification process making them less efficient for thin patients.

Advantages of Using Fat Instead of Implants

Natural Solution For Women Who Want to Avoid Implants

A breast augmentation with fat is a natural method where fat is essentially transferred from “point A” to “point B” without being altered or manipulated artificially. There is zero possibility that a patient's body will subsequently reject its own fat.

2-Fold Benefit of Lipo + Natural Breast Enhancement

Many women have “problem areas” that they would like improved where fat can be repurposed to augment the breasts. Common problem areas are arms, armpits (axilla), back (bra fat), abdomen, flanks (love handles), waist, thighs, and neck. Treating these areas is the ultimate 2 for 1 procedure as patients benefit from both the slimming effects of liposuction and the breast enhancement from the fat transfer.

Fuller Breasts That Adapt
with You Over Time

Fat transfer is also a "one and done" procedure meaning transferred fat becomes a permanent part of the breasts and will change naturally with your body. It will stay with the patient forever responding just like normal fat. Breast implants are not permanent medical devices and need to be replaced periodically; about every 10 years or so. While augmentation with implants is a relatively simple procedure, it is still surgery and can be costly and inconvenient longterm.

Other Variables To Consider with Implants

Implants also can have other problems such as implant malposition (bottoming out), capsular contracture,  implant failure (leaking and silent rupture), asymmetry, implant visibility (rippling), animation deformation (movement of the implant with flexion of the pectoralis major muscle), and an unnatural appearance with improper implant selection.

Fat Transfer After Explant

Before and after explant with immediate fat transfer and breast lift by Dallas Plastic Surgeon, Dr. John Burns MD in Dallas, Texas

Fat transfer can be performed for patients who wish to permanently remove their breast implants in an explant procedure. When a breast implant is removed, there is generally a lot of excess skin, causing the breasts to appear droopy and deflated. In some cases, the remaining breast tissue can develop adhesions where excess skin scars down to the chest, causing severe deformity. A fat transfer can replace much of the implant volume creating a natural shape while preventing deforming adhesions at the breasts.

Mini Breast Augmentation


How Is The Procedure Done?

Fat transfer breast augmentation is essentially a sophisticated liposuction procedure that transforms unwanted fat into natural breast enhancement. Here's how it works:

Harvesting Fat

Using a super wet tumescent technique, excess fat cells are carefully collected from areas where it is unwanted. This fat undergoes a meticulous purification process, separating it from tumescent and body fluids. After being washed and treated with antibiotics, the purified fat is ready for re-injection into the breasts.

Specialized Equipment Matters

The procedure is extremely technical and demands specialized equipment for optimal results. Unlike basic liposuction tools that expose fat to the environment and can be slow, the right equipment ensures pure fat, minimal exposure, efficient transfer, and improved graft take with less risk of fat necrosis. Otherwise, patients will face a subpar result and a possible future breast revision procedure from from decreasing the amount of fat survival, hardening of fat, and fat necrosis. 

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Why Your Plastic Surgeon's Expertise Matters

A surgeon's skill set is vital to achieving ideal results. Precise placement and spreading of fat by your plastic surgeon are crucial, aiming for an optimal tear-drop, natural breast shape. Using a low-pressure pump prevents undue pressure, reducing the risk of fat necrosis. Experience and a deep understanding of the procedure are crucial for achieving beautiful and natural results.The goals of an ideal fat transfer are to achieve a beautiful and natural breast shape, limit fat necrosis, and maximize fat transfer survival. Achieving these goals takes experience and a keen understanding of the procedure.

Before and After Fat Transfer Breast Augmentation- Dallas, Texas- Dr. John Burns Jr., MD

fat grafting to the breasts- Dallas, Texas- Dr John Burns MD
Before and After Fat Grafting to Breasts- Dallas, Texas- Dr. John Burns
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Fat Transfer Breast Augmentation For Thin Patients

Thin patients present unique challenges, as harvesting enough fat while minimizing liposuction outcomes can be tricky. "Skimming" is a technique where small amounts of fat are taken from multiple areas like the abdomen, flanks, and thighs. Careful removal prevents irregularities, and patience is key in achieving smoother results.

Breast Contouring in Thin Patients

Contour irregularities are challenging to avoid in thin patients, but experience is vital for achieving smoother outcomes. A 1:1 super wet tumescent technique is used with small cannulas to remove fat slowly from different areas and trajectories, avoiding telltale signs of over-liposuction. Using multiple vectors ensures a crosshatched pattern for a smoother result. Deep liposuction, preferably with VASER or ultrasound assistance, minimizes irregularities.

VASER Ultrasound-Assisted Liposuction

In some cases, VASER ultrasound liposuction is used by Dr. Burns to enhance smoothness and firm the skin from donor sites in the fat-harvesting process. This technique involves using ultrasound to break up and loosen up the fat before fat extraction.  Careful settings are crucial to avoid harm to fat cells. VASER is particularly useful for very thin patients, those with previous liposuction, or difficult-to-remove fibrous fat.

Understanding the intricacies of fat transfer breast augmentation, combined with a surgeon's expertise and the right equipment, contributes to achieving the desired natural breast shape with minimized complications.

Reasonable Results To Be Expected

Fat transfer is not the same as an implant augmentation and should not be expected to give the same results. Fat is a thick liquid that will grow into natural breast tissue, creating a very natural augmentation of your existing breast tissue. In most cases, fat will give about a one-cup size increase in breast size while maintaining an overall more natural shape.

After the fat grafting procedure, your breasts will be swollen with some fluid retained in the fat. Over the first month the swelling and fluid resolve so that after one month you see the result of the breast fat transfer procedure. At this point, most patients retain about ⅔ of the fat that is placed and about ⅓ is absorbed by the body.

Because there is a lack of breast tissue in the upper poles, fat transfer doesn’t give much upper pole fullness that might be desired by many patients. Also, fat transfer doesn’t give much cleavage or a “round” shape. It is important to consider the amount of augmentation desired and understand that fat rarely gives more than approximately a 1-cup size increase.

Weighing Your Choices For Fat Transfer Versus Implants

Because they are solid structures, breast implants have several advantages over fat grafting. Implants are precise and give exactly the amount of increase desired. For example, a 300cc implant will always give a 300cc increase in size whereas fat is less precise as some of the fat will be absorbed by the body. Fat can give as much volume increase as desired. On average, most women want about a 2 cup size increase which implants can reliably provide but fat cannot. If upper pole fullness and cleavage are desired, breast implants also produce more roundness and shape. Implants are also constant and resist changes in body weight to keep your breasts a relatively stable size.

Learn more about Dr. Burns' Rapid Recovery Breast Augmentation

What's A Reasonable Cup-size Expectation For Women? 

Fat transfer can give about one cup size increase on average by augmenting what a woman naturally has. Fat is somewhat unpredictable as some women seem to retain more fat than others. Fat can give more than a cup size increase but these cases are more unusual and not the norm. Generally, women with more donor site fat and more breast tissue to place the fat into seem to retain more fat than women with less donor site fat and a lack of breast tissue.

Fat Transfer Recovery

This is a full-body cosmetic procedure and the liposuction part requires the most immediate recovery. Patients can expect to be sore from the liposuction; even more than the breasts. As with any liposuction procedure, there will be some drainage from the liposuction sites and early stiffness, soreness, and swelling. Compression garments are worn around the clock. Many patients will do manual lymphatic massage which is massage therapy designed to enhance the body’s lymphatic system. This helps a lot with soreness, stiffness, and swelling. The breasts require a snug but not tight post-surgery bra to hold the fat still and the breasts in good position during the early healing phases. Most patients can get by on Tylenol or Advil/Motrin but some narcotic pain medication may be necessary. Patients will be instructed to take several days of antibiotics to prevent infection.

Post-procedure Garments

Garments are a mainstay of any liposuction procedure. Garments function to press the skin tightly over the body so that the liposuction areas heal smoothly without contour irregularities. Patients are provided with a Stage I (very tight) garment at the time of surgery. This garment is worn for the first 3 weeks and then the patient is cleared for a Stage II (more breathable fabric) garment such as Spanx. Stage I garments are worn for 3 weeks and then Stage II garments are worn for the next 3 weeks for a total of 6 weeks.

1-2 weeks Post-surgery

After the first week, patients can start very light exercises such as walking with no lifting or bouncing type exercises. The soreness will be much improved and patients are clear to drive off their pain medication. Activities of daily living are permitted and encouraged although patients may feel tired and still sore.

1 Month After Fat Transfer Augmentation

At one month patients can increase their activity levels with the addition of more aerobic activity and some very light lifting.

3-4 Months 

At 3 months patients are cleared to return to all normal activity. Bras are worn during the day but can be removed at night. The result will be apparent although some swelling may improve over the next 3 months.

6 Months

The breasts and body have achieved their final appearance and patients can maintain the result with proper diet and exercise.

Fat Transfer Recovery


The breasts and body have achieved their final appearance and patients can maintain the result with proper diet and exercise.

Retention Rates

Fat retention is variable and some patients may retain more fat than others. It is important to differentiate the early swelling and fluid from fat graft resorption. At about one month the fat transfer volume will be apparent and at this point, an average of ⅔ of the fat is maintained permanently.

Fat Necrosis

If fat is placed in too high a volume some fat may get firm due to scarring. This is known as fat necrosis. Fat necrosis is typically small and usually resolves over time. If the areas are large or deforming then it can be removed in a subsequent procedure.

A Nice Compliment To Other Breast Rejuvenation Procedures

  • Fat transfer goes well with any liposuction procedure to re-purpose the fat. Once the fat is discarded the potential to use the fat for breast augmentation is lost.
  • Fat transfer is commonly done to replace implant volume after breast implant removal (explant surgery). This is an excellent way to reconstruct the breast after explant.
  • Fat transfer can be combined with a breast lift if more volume is desired. Fat transfer is commonly done with a Mommy Makeover procedure to re-use the fat and augment deficient areas such as the breast and buttocks (BBL).

When Will I See My Final Results?

During the initial month, changes in size are mainly because of swelling and the body absorbing fluid from the fat transfer. After one month, patients will observe their appearance with only the remaining fat graft. Around two-thirds of the fat graft typically survives, while about one-third is absorbed by the body. By the 6-month mark, when the fat is considered stable, this generally increases about one cup size.

Frequently Asked Questions

Is fat graft to breasts worth it?

Fat transfer is “worth it” for those women who desire liposuction and are happy with more natural-looking breasts. Women should have realistic expectations and understand that the breast will retain its natural shape and increase in size by about one cup only. Patients who want more upper pole fullness, volume, roundness, and cleavage might be happier with breast implants

How long does fat grafting to breasts last?

After about 6 months the amount of fat retained should be permanent. Fat is incorporated into the breast tissue and becomes a permanent part of the breast. Some of the fat may be absorbed into the body and go away. Patients can expect on average about ⅔ of the fat to be permanent.

How much does fat grafting to breasts cost?

In my practice fat transfer is more expensive than implants because of the time it takes and the liposuction component. Liposuction takes time as done with precise placement of the fat into the breast. The cost of fat transfer is about $10,000 and includes all liposuction, surgeon’s fee, facility/operating room fee, board-certified anesthesiologist, and recovery compression garments.

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Plastic Surgery Financing

The surgery is considered elective and not covered by insurance. The cost of surgery is determined by the surgeon's fee, anesthesia fee, and operating room fee. For those who prefer to review financing options, Dr. Burns' practice recommends financing with CareCredit, Alphaeon, and PatientFi.

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Dr. John Burns

Schedule your private consultation with Dr. John Burns.  Dr. Burns offers both virtual and in-office plastic surgery consultations for men and women seeking cosmetic rejuvenation in Dallas, throughout the United States, and the world.

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