Breast Lift with fat grafting

Since 2008, Oslo Plastic Surgery has performed breast augmentation with our own fat tissue, and we have operated on over 250 women. We created this offer as an alternative to breast augmentation with implants. Oslo Plastic Surgery therefore has a long follow-up period for these operation patients, who have proven to be very satisfied with their operation, and that the fat volume in the breasts has remained stable.

Fat grafting from one’s own body is a well-established clinical method that has existed for many years. Although small fat injections for minor irregularities in breasts have been carried out in the past, it is only relatively recently that people have started to use their own fat to recreate a completely new breast either after illness or for cosmetic reasons. Breast treatment with fat of varying types and causes is the clinic’s main area of focus.
Dr. Kalaaji has also published several articles about this in the medical magazine «Kirurgen» and in «Body Language journal», and in his forthcoming book on fat grafting and regenerative surgery:

Plastic and Aesthetic Regenerative Surgery and Fat Grafting Clinical Application and Operative Techniques, published by Springer Nature by editor-in-chief our clinic senior physician Dr. Amin Kalaaji, senior physician, MD.

A lot has happened technically, and developments have led to a gentler method so that more of the fat survives the transplant in the body. In addition, the indication for using fat in the breast has expanded to include, in addition to small breasts, asymmetrical breasts, tuberous breasts, the Hybrid method (fat & implant) and Conversion (replacing the implant with fat). These indications have come partly due to ALCL admission and BII in addition to the fact that more and more people want a more natural shape and consistency on their breasts.

Hybrid and ACL BII info

We are proud to announce that we have presented our results at lectures and guest lectures from 2010 to now around the world as invited faculty in Oslo, Linköping, Karlstad, Helsinki, Berlin, Rome, London, Paris, Qatar, Las Vegas, Tunisia, Gothenburg, Marseilles, Paris, Cairo, Lebanon, Dubai, Manchester (UK), Italy and Copenhagen, EASAPS, ISAPS, IMCAS, SOFCEP and the prestigious ‘Botti Beautiful Breast Meeting’, to name a few.

Among our patients, the most common reason for choosing this procedure is to enlarge the breasts due to a lack of volume, shape and to correct asymmetry (unevenness).

There may also be women who have small and empty breasts after undergoing pregnancy and breastfeeding or women who have an underdeveloped bust.

Many do not want to insert foreign objects such as silicone implants but want something that feels natural. Some people already have implants but want to get more fullness in their breasts without having to change to larger implants. Some women, preferably those who are slim and have a small layer of fat under the skin, can form small folds in the prostheses that can be seen and felt so-called Rippling. An alternative may then be to transplant fat. Some choose to undergo a so-called Hybrid breast treatment with both fat and implants.
Fat can be moved to the breasts at the same time as implants are inserted or fat can be inserted at a later time in those who already have implants to increase volume, correct asymmetry or correct rippling caused by the implant in thin patients or for those patients who have prostheses just below the mammary gland. Other women have inserted breast implants which they now wish to remove completely and instead insert fat to replace the missing volume. (Conversion treatment=changing prostheses for fat grafting). Patients who experience capsule formation and who initially want to remove the prostheses can also benefit from this operation.

In addition, most people who want breast augmentation with their own fat tissue have an unfavorable fat distribution where you want to correct the amount of fat on e.g. stomach, outside or inside thighs, seat or waist/sides so that it becomes a win-win situation. Another advantage these patients seek is to avoid scars which an operation with an implant leaf behind.

Breast augmentation with your own fat tissue can be done as a combined procedure such as a so-called ‘Mommy Makeover’ with e.g. tummy tuck or buttock augmentation with your own fat. The procedure only produces small scars of a few millimeters, and these are barely visible afterwards.

Who can be a candidate for breast augmentation with their own fat?

Among our patients, the most common reason for choosing this procedure is to enlarge the breasts due to a lack of volume, shape and to correct asymmetry (unevenness).

There may also be women who, after going through pregnancy and breastfeeding, or women who experience a loss of volume or those who have little developed bust in the first place but want more volume.

Many do not want to insert foreign bodies such as silicone implants but want something that feels natural.

Some people already have implants but want to get more fullness in their breasts without having to change to larger implants.

Some women, preferably those who are slim and have little subcutaneous fat, can form small folds in the prostheses that can be seen and felt (so-called rippling). An alternative may then be to transplant fat. Some choose to undergo a so-called Hybrid breast treatment with both fat and implants.

It can be adding fat to the breasts done at the same time as inserting implants or adding fat on a later occasion to those who already have implants to increase volume, correct asymmetry or correct rippling caused by the implant in thin patients or for those patients who have prostheses just below the mammary gland.

Other women have inserted breast implants which they now wish to remove completely and instead insert fat to replace the missing volume. (Conversion treatment=changing prostheses for fat grafting). Patients who experience capsule formation and who initially want to remove the prostheses can also benefit from this operation.

In addition, most people who want breast augmentation with their own fat tissue have an unfavorable fat distribution where you want to correct the amount of fat on e.g. stomach, outside or inside thighs, seat or waist/sides so that it becomes a win-win situation. Another advantage these patients seek is to get rid of the scars that an operation with an implant leaves behind.

Breast augmentation with own fat tissue can be done as a combined procedure such as with Mommy Makeover with e.g. a tummy tuck or butt augmentation with your own fat.

The procedure only produces small scars of a few millimeters, and these are barely visible afterwards.

Now you can see the result of breast augmentation with your own fat tissue via a simulation program already during a consultation at Oslo Plastic Surgery.

Our experience shows that not all patients who attend a consultation at Oslo Plastic Surgery are recommended breast augmentation with their own fat tissue. First, the attitude and motivation must be present, and you must also have enough fat to shed. Here it is worth noting that body contouring (liposuction) carried out during such an operation should not only be about «harvesting fat from one or more places» but must be put in context with creating symmetry and figure adaptation to both affected areas and to the body as a whole.

Another requirement is that you must have realistic expectations of getting medium-sized breasts. With today’s experience, this technique is limited by the fact that too large breasts cannot be created, as can be achieved with breast implants with silicone. Implants will therefore be used for breast augmentation in those who are not candidates for this operation.

During the consultation, your wishes and needs are thoroughly assessed with regard to the whole and the area from which the fat is to be removed, so that, as mentioned, you combine two operations at the same time, namely figure shaping (liposuction) and breast augmentation.

How to perform breast augmentation with your own fat

For breast augmentation with own fat tissue, small tunnels are prepared under the mammary gland, alternatively in the pectoral muscle where the fat is built in layers without pressure. The fat is taken out and treated in a special way before it is injected with a special cannula in the chest area, the so-called Coleman’s technique or which we have recently started using; a vibration technique with the MicroAire machine that creates more space for fat in the breast and stimulates healing, which leads to better retention of the fat and thus better results. The amount of fat needed for the procedure depends on the desired volume of the breasts. With a standard fat injection, small scars of approx. 3 mm where the needles are inserted.

Resorption of the fat and long-term result

The result of this type of surgical technique depends on resorption of the injected fat, i.e. the extent to which the body itself absorbs the fat. Usually, the fat is incorporated (grows) well in the recipient area. You must expect that the body absorbs up to 40% of the amount of fat in the first months, therefore you fill a little more than you need (overcorrect) to compensate for this loss. There is also no guarantee that someone will absorb more than 40%.

Handling the fat is crucial for it to grow firmly. There are several conflicting techniques for processing the fat that is removed so that only pure fat is injected. The fat must be treated carefully without major damage to the fat cells. A centrifugation process in which a simple machine separates the fat is considered to meet these requirements. But here the last word has not been said. We use a low degree of centrifugation to separate the fat but retain the intimate fat fluid that supplies the fat cells with, among other things, the natural growth factors, and stem cells that we think give the best possible result.

It is not uncommon for a new injection to be needed, and in case of resorption of more than 40%, a new fat injection is offered within the warranty period; this on the condition that there is sufficient fat for injection for any volume increase or in cases where asymmetry occurs. If the fatty tissue is not sucked away from the body, so that the volume is not satisfactory, this remains a natural and long-lasting result.

Complications

Of the complications, bleeding and infection are uncommon and in very few cases require reoperation and/or treatment with antibiotics. Asymmetry, fat cysts and small calcifications may occur, these may be removed as necessary. Anesthetic complications, such as allergic reaction to anesthetics is extremely rare.

It is suspected that the injected fat may have a role in causing breast cancer. However, it has not been proven that the injected fat has a contributing role in the increase of breast cancer, or whether it could lead to new cases of cancer becoming more difficult to detect both with regard to regular examination and mammography/ultrasound. see the report from the USA and the report from France

Fat injection in the breasts should not be an obstacle to the detection of cancer at a later MRI or ultrasound of the breasts. We recommend taking an MRI or ultrasound/mammography of the breasts before breast augmentation and at the one-year check-up to rule out cancer. You will receive a referral from us during the consultation. Furthermore, normal follow-up routines apply.

When breast augmentation with own fat tissue is not recommended

Women with breast cancer in the family are advised against this type of operation. Women who expect a large breast volume and who lack areas of the body with excess fat, which would like to be corrected, will also not be recommended this operation.

It should not be difficult to detect cancer after fat grafting ation as we always refer to ultrasound before the operation to confirm the starting point so that it is easier to detect cancer.

Does breast augmentation with own fat tissue cause breast cancer? Is it difficult to detect cancer after fat grafting to the breasts?

Nothing has been documented to show that fat injections into the breast are harmful in any way, nor that it induces breast cancer. This method has even been used on patients who have undergone breast cancer surgery to build up their breasts with good results. *

* Kaoutzanis C1, Xin M, Ballard TN, Welch KB, Momoh AO, Kozlow JH, Brown DL, Cederna PS, Wilkins EG. Autologous Fat Grafting After Breast Reconstruction in Postmastectomy Patients: Complications, Biopsy Rates, and Locoregional Cancer Recurrence Rates. Ann Plastic Surg. 2016 Mar;76(3):270-5. doi: 10.1097/SAP.0000000000000561.

It should not be difficult to detect cancer after fat grafting as we always refer to ultrasound before the operation to confirm the starting point so that it is easier to detect cancer.

Video

Pick-up and accommodation

If you live some distance from the clinic, we recommend that you spend one night in or near Oslo Plastic Surgery Clinic so that our caring staff are on hand to reassure you should any issue arise, that will cause you concern.

You must agree in advance with a person to pick you up at the clinic approx. 1 hour after the end of the operation, as you cannot drive, take public transport or taxi alone. You should also have someone with you the same day and the first night.

If you live far from the clinic, we recommend that you spend the night in Oslo, either with family / friends or at a hotel.

Hotels near Oslo Plastic Surgery.
-Frogner House Apartments, Bygdøy Allé 53. Website: https://frognerhouse.no (We have an agreement with Frogner House Apartments).

-Hotel Gabel’s Hus in Gabel gate 16. Website; www.nordicchoicehotels.no

Pre-Operation preparations

To get optimal results and avoid complications

Avoid stress, stay out of the sun, eat healthily, keep your weight within a normal BMI range, exercise regularly, and refrain from alcohol for 2 days prior to surgery and 2 weeks after surgery. Please refrain from smoking/snoozing for at least 2 weeks before surgery and a minimum of 2 weeks after surgery as smoking can interfere with the result.

Before surgery

You must ensure your personal health on the day of surgery. Please contact us as soon as possible if you are in doubt, as we may have to postpone your surgery therefore saving you a journey to our clinic.

Prior to surgery you will have received a prescription for antibiotics, pain killers and Hibiscrub 40 mg/ml which are all available from your local pharmacy. The day before surgery you must shower using the Hibiscrub and again on the day of the procedure immediately
before surgery. Use a clean towel for drying and put on clean clothes when you leave home and change the sheets on your bed.

YOU MUST NOT EAT ANYTHING 6 HOURS BEFORE SURGERY, but you may drink water and light juice (not milk) and chew gum up to 4 hours prior to your surgery. You may take necessary medication/s with a sip of water on the morning of the operation.

Please decide for an adult friend to pick you up after surgery, as you will not be able to drive or take a cab alone. We also advise you to have a responsible adult person staying with you during the first 24 hours.

Taking medications prior to surgery:

It is very important that you stop using the following medications 2 weeks before surgery: Acetylsalisyre, Albyl, Albyl-E and other medications that cause extended bleeding as Ibux, Alka-Seltzer, Antineuralgica, Asacol, Artrizin Alka, Brufen, Butazolidin Alka, Codacetyl, Confortid, Dispril, Dispril med kodein, Doloxene Forte, Denobid, Felden, Fenylbutazon, Gamaquil Comp, Globentyl, Globoid, Indocin, Kodein-Magnyl, Kodifen, Licyl, Magnyl, Magnyl-Koffein, Mundisal, Napren, Naprosyn, Novid, Novid with koffein, Paraflex Comp., Tanderil, Vitamin E, and Selen, Tricycliske antidepressiva.

We also recommend you omit
Garlic, evening primrose oil, Gingko Bilabo, Aspirin and any drug containing blood thinners.

The above products are known blood thinners therefore not beneficial when you are having surgery.

For Marivan we have individual arrangement. Please request this information on your consultation.

Day of Surgery

After a final discussion with your surgeon the planning process will begin. You will be photographed, and markings will be made on your surgical areas. At this stage you will have time and the opportunity to ask any questions that you may have forgotten so that your surgeon can reassure you that he fully understands your goals and expectations.

You will be introduced to your anesthetist (who will be happy to discuss any fears or issues you have regarding your anesthetization). You will also meet your theatre nurse.

The sedation which you are given in your arm is a quick and painless procedure and you will fall asleep very quickly.

The procedure itself takes approx. 1-1 ½ hours, under deep sedation. As a rule, the incision is made where the old scar is, this is to avoid creating new scars. After removing the old prosthesis, the same cavity will be used to fill it with the patient’s own fat. It often puts a drain in the pocket, which is usually removed 1-2 days after surgery.

You should be ready to go home within 1 hour following surgery and remember to arrange for someone to pick you up. You should have adult company with you for the next 24 hours to assist you with general tasks, so that you can relax and take it relatively easy.

We will provide you with the cell phone numbers to call us should you feel the need, but this is very rare. We just need to reassure you that we are there for you 24 hours a day.

After Surgery

We will require you to come to the clinic for a follow up check. WITH ALL SURGERY THIS IS IMPORTANT AS YOUR SURGEON NEEDS TO SEE HOW YOU ARE SETTLING.

We do not recommend you fly for 48 hours post-surgery. You may feel nauseous and tired in the hours following surgery. It is important to take your painkillers and drink enough fluids.

We close the wound with stitches that dissolve on their own. We do not usually insert the drain (tube), only in very few cases is it inserted to remove blood and fluid from the wound area under the chest. These are usually removed at the clinic 1-2 days after the operation.

You may experience dizziness if you get up quickly from a chair or perhaps when you are lying in bed, so be sensible, take it easy and move slowly. This is quite normal following surgery and should pass within a couple of days.

The first 2-5 days following your breast surgery you may feel stiff and sore in the chest region. You should be calm and lie as still as possible, with your upper body raised. For the next five days, you can move gently. If you have an active job, it is a good idea to stay home.

After the operation, you get a special bandage that is removed after 2 days, the tape is kept on for 2 weeks. You will be required to wear a sports bra for approximately 6 weeks after surgery day and night and 6 more week at daytime. Your breasts may feel tight and sensitive to the touch and your skin may feel warm or itchy.

After the tape is removed (after 2 weeks) you can shower the area and put on new tape. It is recommended that you tape the scars with skin-friendly tape for at least 2 months. Surgical tape such as Micropore or Steri-Strip can be bought at the pharmacy, alternatively silicone tape.

Follow ups will be carried out at the clinic/alternatively through phone or video consultation:

1 day after surgery, after 1-2 weeks, after 3-6 months and finally after 1 year when our guarantee to you is completed.

Bleeding and infection are unusual and if they do occur, they may need to be treated with a small operation and/or an antibiotic. Asymmetry, incorrectly placed implants, or the formation of hard capsules” capsular contracture” can also occur. If corrections are needed, they will be scheduled free of charge within one year after your surgery. Anesthesia allergy is extremely rare.

If correction is necessary due to complications or unsatisfactory results, this is done free of charge within one year if there is a medical indication and a clear potential for improvement. This is our warranty period.

Heavy physical exercise and strenuous body movement or lifting must not be undertaken for a minimum of 4 weeks following the surgery.

We recommend protein-rich foods post-op and for 8 weeks after a fat transplant. Eggs, dairy products (milk, yogurt, cheese), meat, bird and fish, grain products, legumes (lentils, beans, peas) and nuts are high in protein. It is also important not to lose weight after a fat transplant to maintain volume and shape after the procedure.

The results will emerge between 3 to 6 months following surgery.

On this page you will find:

Contact form

If you want to know more or have questions, use the form and we will reply to you within a short time.

Dr. Amin Kalaaji

The responsible physician is Dr. Amin Kalaaji, senior physician MD, specialist in plastic surgery and head of clinic at Oslo Plastic Surgery, and head of the Norwegian Association for Aesthetic Plastic Surgery (NFEP) 2018-2020.

Dr. Kalaaji holds many positions and gives lectures and training around the world. This benefits all our patients as he is always up to date on the latest and most advanced treatments and surgical techniques.

Patient safety, high quality and individual treatment always weigh the most at Oslo Plastic Surgery.

FAQ

Oslo Plastikkirurgi answers here frequently asked questions, and we hope that this will give you good information. We want to be helpful in the process before an operation. If you have more questions, just write or call us.

Why do you choose breast augmentation with your own fat and not prostheses?

Breast augmentation with your own fat can be a good alternative to prostheses in selected patients to enlarge the breasts in addition to filling desired areas where there is sagging, little filling or asymmetry and at the same time removing unwanted fat on the body.

Am I a candidate for breast augmentation with my own fat?

You must meet the following requirements to be a candidate for breast augmentation with your own fat: a desire not to insert foreign bodies, have existing fat for correction, have a realistic expectation of volume increase, normal ultrasound/MR of the breast, no family history of breast cancer.

What kind of result can I expect?

You can expect a natural result and small scars that are barely visible afterwards. You will not be able to achieve the same large breasts as with the insertion of prostheses.

Where can I get fat from?

Fat is usually harvested from the abdomen, thighs, and sides, but can also be harvested from other places on the body. Your wish will be important here.

Will my breasts be much larger after the procedure?

Your breasts will be somewhat larger after the procedure, depending on how much fat you have on your body that can be moved and how much will be absorbed into the breasts. You will receive more information about this at a consultation, in addition to a 2D or alternatively 3D simulation.

Will I get slimmer in the places I take fat from?

Liposuction in conjunction with breast augmentation with your own fat is not a slimming method and we recommend that you be at your ideal weight at the time of the procedure so that the result is the best possible. Unwanted fat from the selected areas will be gone.

Does breast augmentation with own fat cause breast cancer?

It should not be difficult to detect cancer after fat grafting ation as we always refer to ultrasound before the operation to confirm the starting point so that it is easier to detect cancer.

What if I am not satisfied after the operation?

We have a one-year guarantee on the operation and if, up to one year after the operation, there is a medical indication for an unsatisfactory result, a new operation/correction can be calculated free of charge.

How long does it hurt in the chest area after the operation?

For the first two days after the operation, you must rest. You will experience some pain, and occasionally nausea. It is important that you take painkillers as prescribed and make sure you drink plenty of water for the first 24 hours. The pain will be individual, but basically you should be able to move freely the next day.

Can I breastfeed or become pregnant after such an operation?

You can have children and breastfeed after such an operation.

Will I get a natural result?

With breast augmentation with your own fat, you will get a natural result because it is your own fat that is injected into the breasts. You will not get as large an increase in volume as with prostheses, but fat can be added in several sessions for volume building.

Will I get scars?

You will only get 1-2 mm small scars at the places where fat is taken from and where it is reinserted into the breasts. These scars will become weaker over time, but scarring is also individual, and some will form more scars than others.

How long do I have to use compression in the places where I remove fat?

After 5-6 days, you can take off the bodysuit and, if necessary, shower the areas that have been liposuction, apply new tape and then put the bodysuit back on. The body must be worn day and night for the first 6 weeks, and then during the day for 6 weeks. You must wear a sports bra for 6 weeks after the operation (not a sports bra).

How long do I have to wear a bandage?

After two weeks, you can shower and put on new tape (same place as you received after the operation). You can remove the tape when the wounds have healed. You must wait until four weeks after the operation to use a normal bra.

When can I train or work again?

Vigorous physical training and hard physical work are not recommended for approx. two weeks after surgery, but you are completely mobile and can resume daily activities already the day after surgery.

How does a consultation take place?

All patients must have a consultation before the operation. The consultation is conducted by our experienced plastic surgeon who will confer with you and your medical condition and motivation for surgery. An examination is then performed, and the surgeon assesses a possible operation.

If you are suitable for the procedure, you will receive information about the procedure, precautions for the time before and after the procedure, and you will receive answers to your questions. We then photograph the breasts and take important distance measurements to assess the need for an implant. You then get to test a special bra prosthesis, both sizes and shapes. We show several before and after pictures and if desired we can make 3D animation of the result. Feel free to tell us about this before the consultation so that we can calculate well in time.

In a consultation you get a prescription for antibiotics, possibly painkillers and Hibiscrub solution 40 mg / ml which you can buy at the pharmacy.

What happens on the day of the operation itself?

You must be healthy on the day of surgery. If you are in doubt about whether you have a cold or the like, you must contact us. The operation is not performed when you have the flu and / or fever or cough or other infection in the body. Our staff will receive you and together complete you for the operation, the surgeon looks at you before the procedure and draws up the planned procedure, as well as answers your questions. Anesthesia staff also come to greet you and answer your questions. After the operation, you will be served food and plenty of drinks in the form of bread, yoghurt, and juice (tell us if you want another diet / have allergies).

Do you get to see other people's before and after pictures before an operation?

In Norway, it is not allowed to show before and after pictures from cosmetic procedures during marketing or on the clinic’s website. However, we can show great pictures from previous patients when you come for a consultation with the surgeon. This can be very helpful when choosing the shape and size of the implant, and it can make it easier for you to imagine a result. We do not send photos.

What guarantee do I have for the operation?

We have a 1-year warranty. If correction is necessary due to complications or unsatisfactory results, this is done free of charge within one year if there is a medical indication and a clear potential for improvement. This is our one-year warranty agreement.

How much does breast augmentation with your own fat cost?

The price of breast augmentation with own fat tissue starts at NOK 46,500, but varies from person to person depending on the number of areas the fat is taken from and how much is inserted. You will receive a specific price during a consultation with our plastic surgeon. Included in this price is everything from anesthesia and the special bra you need for 2 days after the procedure.

Attachments:

1 – IPRAS Journal, Issue 8, 2012

2 – Kirurgen tidsskrift 2016, (25. Januar 2016)

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