Explant with Fat Transfer

For patients who want to restore some volume after implant removal but prefer to avoid placing new implants, autologous fat transfer offers a natural alternative — using your own fat, harvested from another area of the body, to add gentle volume and improve breast contour.

Explant with fat transfer (lipofilling) combines breast implant removal with autologous fat grafting to restore moderate volume using the patient's own tissue. Typical volume gain is 150-300cc per breast per session, with 30-50% fat resorption over 6 months. Bonus body contouring at the fat harvest site (abdomen, thighs, flanks).

Why fat transfer instead of new implants?

• No foreign material: Your own tissue, no future revisions or replacements needed
• No capsule formation around foreign body
• Natural feel and movement
• Body contouring bonus: The harvest area (abdomen, thighs, flanks) is slimmed
• No long-term implant monitoring required

Honest limitations

• Fat resorption: 30-50% of transferred fat is reabsorbed within 6 months; only what survives is permanent
• Multiple sessions may be needed for patients wanting more volume
• Adequate donor sites required: Very thin patients may not have enough fat to harvest
• No upper-pole fullness like implants can create
• Imaging considerations: Fat necrosis and calcifications can appear on mammography (radiologist should know history)

Surgical steps

1. Implant + capsule removal — explant performed first
2. Liposuction harvest — fat harvested from selected donor sites (abdomen, flanks, thighs)
3. Fat processing — purification by centrifugation or filtration to isolate viable adipocytes
4. Layered injection — small aliquots injected in multiple tissue planes to maximize survival
5. Compression and recovery — both the breasts and donor sites need post-op support

Recovery

• Days 1-3: Bruising and swelling at both breast and donor sites, compression garments worn
• Week 1: Drains (if used) removed, light activity
• Weeks 2-3: Office work, swelling decreasing
• Weeks 4-6: Light exercise resumes, fat survival becoming evident
• Months 3-6: Final volume becomes apparent as fat stabilizes

When fat transfer is not the answer

• Patient wants significant volume restoration → consider new implants instead
• Patient is very thin with minimal fat to harvest → mastopexy alone may serve better
• Strong family history of breast cancer with concerns about imaging clarity
• Active smoker (fat survival significantly reduced)