Breast Fat Grafting Explained by Sydney Coleman
Description of Dr. Sydney Coleman’s Method of Breast Fat Grafting including Consultations, Procedure, and Pricing
My office has received many inquires about the cost and the procedure of breast fat grafting procedures. I have therefore written up the following description of my consultation, some important points of my procedure and some explanations of the cost.
Planning Consultation: The most important first step for fat grafting to the breast is for you to help me design a procedure that will give you the shape and size that you desire for your breasts. I do that by first examining and photographing your body. Then I study the photographs with you. Together we design an individualized plan to change both your breasts and to enhance your body with the harvesting of fat. I draw out blueprints of your unique procedure using pencil tracings that depict your specific body and the changes you seek. I like to color code the blueprint to indicate where I plan to remove the fat, where you desire specific changes in size or shape, and where the tiny entrance sites will be placed (see below). I use the same sheet to make notations as I review your informed consent.
Color-coded blueprint aids the patient in her understanding the procedure and enables the patient to help design the procedure. (Click on the image for a larger version)
Special Considerations: The decision to use the BRAVA system should be made weeks before the procedure. Please refer to my last post for comments.
Marking: On the day of the procedure, I follow the blueprint to mark your body with a color-coded system (see below). This lets you understand from where I am removing fatty tissue and how I am placing it into your breast to improve your shape and increase your breast size.
On the day of the procedure, Dr. Coleman marks the patients with the patient actively participating in the selection of harvest areas as well as the design of her breast augmentation.
Harvesting & Refinement: The procedure for breast augmentation with fat involves first harvesting fat from the body. Some women have enough fat in one location (outer thighs or lovehandles), which makes removal much simpler. However, many women have had liposuction to their outer thighs and lovehandles, or simply do not have enough fat in one area. In those women, I consider numerous areas for harvesting (abdomen, flanks, inner thighs, knees, calves, arms, et cetera). Obviously, this is an important part of the procedure, and you and I will want to design the removal so that your body shape is enhanced and problems are avoided. Because of the amount of fat tissue that needs to be removed, I usually perform the procedure under general anesthesia. However, for much smaller procedures, I use local anesthesia with sedation.
Grading the fat for selective placement: After the fat is harvested, I refine and concentrate the fat tissue using a centrifuge to remove any non-living components (oil, water, blood, et cetera). My experience has taught me to grade the fat into different qualities, depending on density and other factors. I use the graded densities to attain different effects. This is one of the keys to successful fat grafting.
Sculpting while layering in the graded fat: I use the concentrated fat tissue to meticulously sculpt the breast. The technique I developed alters the shape and size of the breast by placing miniscule amounts in thousands of passes through three or four tiny entrance sites located in the lower fold of the breast and the areola. The sculpting requires a three dimensional vision that must happen while the fat is being placed into the breast. Many surgeons place fat then try to move it around.
Price: How is the price determined? First of all, price varies depending on the difficulty of removing fat from select parts of your body, processing and concentrating the fat. If it is going to take me one hour to harvest the fat, then I am able to charge much less than if it will take me two or three hours. Then the difficulty of the meticulous placement into the breast needs to be considered. Previous scarring from implants or surgery will make the procedure more difficult. The more fat I harvest and place, the more that I need to charge. Simple, uncomplicated augmentations start at $20,000. Treating the problems of breast implants with fat grafting is usually less depending on the amount of fat needed to be placed and the amount of scarring present. Reconstructive procedures after breast cancer or from birth defects can often be covered at least in part by insurance.
If you call my office at +1 212 571 5200 my office staff can give you a better idea of the cost if you describe your breasts and body. If you send photographs with a description of your goals, we can give you an even better estimate of the cost.
Check out these links for more information on fat grafting to the breasts:
Combining the BRAVA system with Fat Grafting to the Breast
Fat Grafting to solve problems with Breast Implants
Safety concerns with fat grafting to the breast
The American Society of Plastic Surgery’s Position of Fat Grafting to the Breast
Dr. Sydney Coleman demonstrates Breast Reconstruction with LipoStructure on The Doctors
Coleman lectures on fat grafting for breast reconstruction at the American College of Surgeons
Lipofilling: a role in breast reconstruction surgery From “Behind the Medical Headlines” produced by the Royal College of Physicians of Edinburgh and Royal College of Physicians and Surgeons of Glasgow
Breast Augmentation Via Fat Grafting From “Plastic Surgery Practice”
Breast Implant Problems Solved with Coleman Fat Grafting
Fat Grafting to the Breast Revisited: Safety and Efficacy. Plastic & Reconstructive Surgery. 119(3):775-785, March 2007. Coleman, Sydney R. M.D.; Saboeiro, Alesia P. M.D.
© Coleman 2009
Dr. Coleman,
I’m excited that you have a blog. I had the breast enlargement done by you over 10 years ago and am quite happy with the results, especially the shape and the quality of my breast and decollete skin. And your fat grafting to the breast moved me from a small A to a medium B cup. However, I went through menopause over the last five years, and my breasts decreased a tiny bit down to a slightly smaller B, during that time. I think that I’d like to be at least a larger B cup or maybe even a C cup.
Is that possible?
PL
Lauren,
Please make an appointment for follow-up.
During menopause, many women lose volume in their breast, and they can sag more. Adding more fat to your breast could push your cup size up and help reshape your breasts, but it depends on several things as to how much extra volume is possible in you. The most important factor is your donor sites. You need an adequate volume of fat to harvest.
In addition, by using the BRAVA system, we can improve the blood supply in your breast before the procedure and by keeping it on after the procedure, there is a beneficial effect also in maximizing the effect of the fat grafts.
Again, please call my office 212 571 5200 and either come back for an appointment or arrange for photographs so that I can see your current donor sites and breasts.
SRC
Dear Dr Coleman,
After two failed appointments in London with cosmetic surgeons advertising “stem cell breast augmentation” and “natural breast enhancement” I am about to give up my dream of using my own fat to achieve slightly fuller breasts. I am an A-cup hoping to be a B-cub. On my recent consultation the surgeon said I did not have enough fat on my body to do this procedure. However the first surgeon said he could take fat from my inner and outer thighs. (He had never done the procedure before though, which gave me cold feet!). I am at least 3 kilos heavier than I used to be when I was thinner.
So my questions to you are:
How much fat do I need on my body? The girl on the pictures above with your markings on, looks very slim (much slimmer then I am). Did she have the procedure done or was she just used as a model?
Also, How much of the grafted fat is expected to remain in the breast after the filling? 50 percent or more?
I have worn the Brava system for three weeks now and are hoping to use this in combination with fat grafting. I would love to have the opportunity to come to New York and have this procedure done by you. Is it ok to go on a long flight before and after the procedure?
Kindest Regards,
K
Klara,
Your questions are great and you should proceed with the caution you have demonstrated in your note.
To start off with, you do need some fat on your body, but most healthy women have enough fat on their body to enable a significant (usually one cup size) increase in their breasts. However, the surgeon may need to go to several different sites to obtain enough fat.
The most important warning I can give you is be careful about wasting your fat. Many techniques kill a big portion of the fat. You should go to someone who can show that they have good long-term (more than two years) results. Otherwise, they could possibly waste the valuable fat you have on your body,
The second important warning is go to someone who is an expert in fat removal. If fat is not harvested in an expert, precise fashion, you can be left with horrible deformities in your thighs, waist or buttocks. This happens more often than you might imagine.
The patients of mine that you have seen are not models, but attractively thin women who had the fat harvested carefully usually from several different sites.
The amount of fat that remains after transplantation can vary, but recent studies have shown from 65 to 85% with good technique. The BRAVA system seems to help push that survival to a higher level, and is definitely something you should consider using.
A big percentage of my patients fly from a distance for procedures. A premenopausal woman needs to take special precautions with flying, such as avoiding a long flight immediately before or after any procedure.
If you have further questions, please feel free to call Renee in my office (+1 212 571 5200).
Sydney Coleman
Dr Coleman,
i am a 21 year old woman in Australia with Tuberous (Tubular) breasts. Although my breasts have been this way since puberty i only recently discovered that they were the result of a deformity, and began researching Tuberous Breasts and what can be done. I have been deeply ashamed and insecure of my breasts for years, and am desperate to take action to correct them. I am willing to undergo surgery, but am against having implants, having a foreign object in my body isn’t something im comfortable with and i dislike the look of implants regardless of size. With that in mind i have been trying to research ways to correct my breasts without an implant, and so far my options seem limited. I have read of “tissue expansion” or something in that vein where incisions in the breast are made to loosen the restricted tissue, and a benelli operation to correct the areola (mine is what i believe to be significantly herniated- very puffy, covers the whole breast, very little underside to the breast) and other things similar perhaps to a breast lift operation, and though some surgeons have commented that its not necessary to have an implant to correct tuberous breasts, i have read that without an implant, a correct full shape cannot be obtained, and aside from the large puffy areola, i am very concerned about the wide gap between my breasts, and the “snoopy” effect of the way they “hang”. I dont have large breasts, there isnt a lot of tissue i believe, however i do have more than just the puffy areola as shown in a picture on your site, so i was hoping that there would be enough tissue to work with, without an implant.
I have just started to read about fat grafting to correct tuberous breasts, and it seems like the answer to all of my problems, however i am hesitant to look into a practice that appears to still be developing and not widely accepted, the risks of any breast surgery are very daunting to me, let alone one that is still being trialled. Additionally, the $20 000 minimum price tag pretty much rules it out for me, as i am completely unable to afford it as a student. However, i am incredibly impressed with what i have read of you, and was hoping you could impart some advice about both fat grafting, and also the other implant-free options i could look into. I dont care about an increase in size, the only thing that bothers me is that to me, they truly look deformed and ugly, and i would just like to get them looking ‘normal’. Also, if you are aware of any surgeons in Australia who are known for correcting Tubular breasts without implants, i would be very grateful to hear of them.
Also, even though it is a completely unrealistic pipe dream, if i were to by some miracle be able to facilitate a trip to new york and a consultation with you, roughly how much would it cost to get the grafting, and areola reduction etc performed?
Thank you so much for your time, any advice whatsoever you could give me would be so tremendously appreciated. Thank you, Monique
Is there a reputable doctor in Texas that you could recommend for this procedure.
Dear Dr. Coleman.
I really admire your work, and are planning a surgery based on your fat grabbing method. It’s just genious, since I have a few areas I would like to get liposcupltured, and I would like a breast enlargement as well. =)
My question is, when a clinic decides to use your method, I presume that they would have to send a request to your clinic to get an approval?
If so, is there any sites where I may find out which clinic in which country that practices your fat-grabbing-method?
Sencerely
Ann-Helen Bergan Amundsen
Ann-Helen,
Dr. Coleman has been using his method (know as the “Coleman technique” worldwide), since 1987. It has gone through multiple advances and changes over the decades. Due to the obvious success of the procedure, many physicians have begun to use this technique. Most of them have variable success as they become familiar with the operation, and get better with time and experience.
Because it is impossible for Dr. Coleman to evaluate all of the physicians that practice fat grafting using his technique, it is difficult for us to recommend specific physicians.
If you have any more questions, please call Renee +1 212 571 5200 in our office.
Office Staff of Sydney R Coleman
Thank you for your reply!
Just one more question, since I don’t have the opportunity to call.
Iæve read something about fat grafting to breast using Vaser Lipo ultrasonic lipolysis. Is this a procedure that You are familiar with? Is there a big difference in fat cell survival between this method, and the Coleman’s technique?
Sencerely
Ann-Helen Bergan Amundsen
Dear Dr Coleman,
I am from London and have been looking into having my breast enlarged through fat grafting procedure. I am considering travelling to NY to have this procedure done in your clinic as I have never done any plastic surgery before and want to make sure I am choosing the best option. I have few questions: what sort of liposuction technique do you use to remove the fat from the body before injecting it into the breasts? In London clinic they offer Vaser liposuction technique under local anaesthetic and then it is injected into the breast also using local anaesthetic. Do you perform both procedure under local anaesthetic? I am worried about going under general anaesthetic. Also i do not have kids yet. Is it best to wait to wait till you have children before you do the fat grafting ? i am worried that my weight will fluctuate during pregnancy and that would affect the results of fat grafting procedure.
Many thanks,
Elina