What is breast augmentation with fat transfer?
Autologous fat grafting to the breast, the medical term for breast augmentation with fat transfer, moves living fat from where you have too much to where you want more. Fat is harvested by liposuction from the abdomen, flanks, hips, back or thighs through incisions of less than 4 millimeters, washed so that only intact fat cells are transferred, and injected into the breast tissue in small amounts at several depths, where each parcel sits close to a blood supply and can survive. The fat that takes becomes part of the breast, feels and moves like the rest of it, and leaves nothing to image, exchange or remove later. Dr. Cat calls it natural breast augmentation, the breast augmentation without implants: your breast, a size fuller.
It is one of two augmentations Dr. Cat performs. The other, breast augmentation with implants, adds a fixed, predictable volume of any size, with the fullness in the upper pole that only an implant gives. Fat transfer adds about one cup size, keeps the shape you have, does not lift a breast that has dropped, and cannot create a round upper pole or take you up several cup sizes; dense breast tissue or very tight skin limits the volume further. Dr. Cat does not combine an implant with a fat transfer in the same augmentation: it is one or the other.
Who is a good candidate for fat transfer breast augmentation?
Three things decide it: enough donor fat, breast tissue and skin that will accept the fat, and the wish for a subtle, natural change. Dr. Cat weighs all three at the consultation.
You may be a good candidate if
- You want fuller breasts, about one cup size more, with the shape you have and no implant
- You have fat to spare on the abdomen, flanks, hips, back or thighs
- Your weight is stable, you are in good health, and you do not use nicotine
- Breastfeeding is finished and settled, and no pregnancy is planned in the next year or two
Not yet, or a different plan, if
- You want more than about a cup, cleavage in a bra, or fullness high on the chest: that is an implant
- You are lean, with little fat at the waist, hips or thighs: Dr. Cat says so rather than transfer too little
- Your nipple sits at or below the fold: fat does not lift a breast, so a lift comes first
- You are still losing weight, or you smoke and cannot stop for the period Dr. Cat specifies, two months to a year
How many cup sizes can fat transfer add?
About one cup size from a single transfer. The limit is how much fat you have to donate and how much the breast will accept, because fat packed under pressure into dense tissue or tight skin dies; Dr. Cat fills each breast to what the tissue can hold rather than to a number. A patient who wants two cup sizes, a round upper pole or projection from the side is an implant patient, and Dr. Cat says so at the consultation. Our comparison of implants vs fat transfer sets the two side by side. For two breasts that differ by a small amount, fat is a precise tool; our page on uneven breasts explains how Dr. Cat decides.
Who has enough donor fat?
The harvest is half the operation. For most patients it is a lipo 360 of the upper and lower abdomen, the flanks, the hips and the back, which is why the surgeon's fee includes it; the thighs are added when the trunk has too little. Dr. Cat examines every donor area with a pinch test before she quotes a transfer, and when there is not enough to fill both breasts with a margin for the fat that will not survive, she says so, because harvesting a lean body too hard leaves dents. Fat that is not transferred cannot be banked.
How Dr. Cat does it
Dr. Cat is a board-certified plastic surgeon who completed two surgical residencies, one in head and neck surgery, microvascular and facial reconstructive surgery, and advanced training in general plastic and reconstructive surgery, Harvard-educated and UCLA trained. During her UCLA training she co-authored published research on autologous fat transfer in Plastic and Reconstructive Surgery, and in practice she developed a gentle, multi-phase liposuction and fat transfer technique with very high fat survival and few complications.
Step 1: the harvest, gentle multi-phase liposuction
Fat cells torn during a rough harvest do not survive the transfer, so the harvest decides the result. Each area is infused with a numbing solution, and through incisions of less than 4 millimeters she removes the fat with a thin cannula, tumescent and power-assisted, never a laser, Vaser or other heat device: the fat broken into tiny particles, removed evenly with every stroke counted, and a thin cushion left under the skin so the donor areas stay smooth.
Step 2: washing the fat
Harvested fat is a mixture of fat cells, numbing fluid, blood and oil from broken cells. Dr. Cat has it gently washed rather than spun, so that only intact, living fat goes into the breast.
Step 3: placing the fat in the breast
She places a numbing solution in the breasts as well, then injects the washed fat through tiny entry points in many small passes at several depths, so that every parcel sits next to living tissue that can give it a blood supply. She fills to what the tissue can hold and never overstuffs, because pressure kills the graft, and she checks the two sides against each other as she goes, for even, symmetric, natural-looking breasts in proportion to the body she has just contoured. She considers this surgery an art.
Anesthesia, surgery day and the first night
The surgery is performed under general anesthesia with a board-certified physician anesthesiologist in Dr. Cat's QUAD A accredited surgery center on Rodeo Drive; local anesthesia is possible only in the rare case of a single small donor area. It takes three to five hours by the number of areas harvested, one major surgery per surgical day, every step by Dr. Cat herself. A lipo 360 harvest with fat transfer to the breast needs aftercare: the first night is spent in a plastic surgery aftercare center, with nursing care and the garments checked, and you go home the next morning. Only the rare single-donor-area case goes home the same day, which Dr. Cat sets at your consultation.
Dr. Cat on breast augmentation with fat transferCombining fat transfer to the breast with other procedures
With a breast lift
Fat adds about one cup size but does not move a nipple. When the nipple sits at or below the fold, a breast lift comes first, and in Dr. Cat's practice a lift with fat transfer (mastopexy with fat grafting) is always two surgeries: the lift first, then the fat grafting several months later. The reason is pressure. How much transferred fat survives depends greatly on the pressure in the tissue it is placed in, and a breast lift tightens the tissues and creates a lot of pressure; staged, once the lifted breast has settled, far more of the fat survives.
After breast implant removal
Patients who want their implants out but not all of the volume often choose fat transfer after breast implant removal: your own fat for a modest, natural fullness. Whether it is done with the explant or staged is decided and quoted at your consultation.
The buttocks, the hips and the face
The same harvested fat can go to the breasts or to the buttocks, but not on the same day: Dr. Cat never performs a Brazilian butt lift on the same day as a breast augmentation, because the recoveries contradict each other and the anesthesia would run too long. Fat transfer to the face, which she also performs, needs only a small amount of fat; whether it fits the same day is decided at the consultation.
Fat transfer breast augmentation recovery, week by week
Recovery is mostly liposuction recovery, with one rule for the breasts: no pressure on them while the fat takes its blood supply.
- Surgery dayYou wake numb rather than sore, in a compression garment and a soft bra, and spend the first night in the plastic surgery aftercare center after a lipo 360 harvest, with nursing care. Walking within a few hours, with Tylenol.
- Days one to threeDr. Cat sees you the day after surgery. The donor areas feel like a deep bruise; the breasts are swollen, firm and fuller than they will stay. Sleep on your back, with no pressure on the breasts.
- One weekSwelling in the donor areas peaks around day three and then falls; most patients are off all pain medication, with minimal bruising at the donor sites.
- Two weeksBack at a desk within one to two weeks. Dr. Cat checks the incisions and starts scar treatment; out-of-town patients usually fly home once she has cleared them.
- Three to six weeksLight exercise at about three weeks. The garment comes off at six weeks, when full exercise resumes; Dr. Cat advises against lymphatic massage.
- Three to six monthsThe fat that was not going to survive has been absorbed and the swelling has gone: the volume you see now is the volume you keep.
- One yearThe incisions have faded to almost nothing. The grafted fat is a permanent part of your breast and follows your weight.
How long does fat transfer to the breast last?
The fat that survives lasts for good. Transferred fat arrives without a blood supply; over the first weeks each parcel either connects to the vessels around it and becomes living breast fat, or is absorbed, and the final volume is clear at three to six months. In Dr. Cat's experience more than 80 to 90 percent of the transferred fat survives, which is why her patients rarely need a second round. What remains gains and shrinks with your weight and changes with a pregnancy, so Dr. Cat asks for a stable weight and usually advises a patient planning a pregnancy in the next year or two to wait. A second transfer, for a patient who wants more once the first result is final, is quoted at your consultation.
Mammograms after fat transfer to the breast
Transferred fat can leave small calcifications or oil cysts, and a radiologist can usually tell them from suspicious findings, so tell every mammography center that you have had a fat transfer, with the date. Dr. Cat may ask for a mammogram before surgery, in line with age guidelines.
Fat transfer breast augmentation before and after photos
Look for two things in fat transfer breast augmentation before and after photos: a breast that kept its own shape, a size fuller with a natural slope rather than a round upper pole, and a waist or thighs slimmer in the same frame. The three cases below are Dr. Cat's. Case BAF-2285 wanted a natural increase in size and got a natural shape from her own fat. Case BAF-2292 is a very natural look with more fullness rather than a large increase in size. Case BAF-5321 had 300 cc of fat placed in each breast, for the full shape she asked for. See every angle in the practice's breast augmentation with fat transfer before and after photos; the after photo that counts is at three months or later.
Risks and safety
Breast augmentation with fat transfer carries the risks of liposuction and of fat grafting together, and technique decides most of them.
What can go wrong
- Fat that does not survive: more of a graft is absorbed than expected and the volume falls short
- Fat necrosis, a firm lump where fat placed in a large deposit died, an oil cyst where fat did not take, or small calcifications on a mammogram
- Asymmetry between the two breasts, from uneven placement or uneven survival
- At the donor areas: bruising, numbness, a seroma or hematoma, or dents where too much was taken
- Infection at an incision, a blood clot in the leg, rare and serious, and anesthesia risks
How Dr. Cat reduces these risks
- A gentle multi-phase harvest with thin cannulas and no heat devices, every pass hers, and a cushion of fat left under the skin
- Fat washed rather than spun and placed in many small passes at several depths, never in pools and never overstuffed
- Filling to what the breast tissue can hold, with the two sides checked against each other during surgery
- Careful patient selection: enough donor fat, a stable weight, no nicotine, breastfeeding finished, and medical clearance and lab work
- A board-certified physician anesthesiologist in her QUAD A accredited surgery center, one major surgery that day, and follow-up visits through the months the fat settles
How much does breast augmentation with fat transfer cost in Beverly Hills?
Dr. Cat's surgeon's fee for breast augmentation with fat transfer, which includes the lipo 360 harvest, is $56,500 to $63,500; the operating room and anesthesia are quoted at your consultation, because the operating time depends on your anatomy and on what is treated together. Surgeon's fees are typical ranges: a more complex case can cost more, and your fee is set at your consultation and is final only in your written quote. The fee is one figure for the whole surgery, the liposuction of the abdomen, flanks, hips and back and the transfer to both breasts, not a price per area; a second transfer is quoted at your consultation. Every quote is itemized and in writing.
The price reflects one surgeon who performs every stroke of the liposuction and every pass of the transfer herself, one major surgery per surgical day, a physician anesthesiologist and an accredited facility. Please do not shop fat transfer on price: fat harvested roughly or packed under pressure dies or lumps, and correcting dented donor areas costs more than the operation done well. An augmentation with implants costs less, because the transfer is a liposuction of several areas plus the breast work; our breast augmentation cost guide, written for implants, covers what implants cost and the national picture. Fat transfer is cosmetic and not covered by insurance.
Consultation fee and financing
A consultation with Dr. Cat is $500, or $1,500 for a revision consultation, credited in full toward your surgery. Your surgery date is booked once the quote and the pre-op paperwork are signed and the $2,500 deposit is paid, and quotes are valid for six months. The practice partners with Cherry, its primary financing partner, and also accepts CareCredit and Alphaeon Credit; see financing and payment plans.
Your consultation with Dr. Cat
It starts with a free 15-minute discovery call with our Patient Concierge, who books your consultation. Patients come to Dr. Cat for fat transfer breast augmentation from across Los Angeles and from out of town, and out-of-town patients have a private video consultation through OnPatient, the HIPAA-secure patient portal. Bring pictures of breasts you like. Dr. Cat examines your breast tissue and skin, checks where the nipple sits against the fold, pinches every donor area, takes a complete medical history, and tells you plainly whether fat transfer, an implant, a lift first, or nothing yet is the right plan. You leave with an itemized written quote.







