A short YouTube conversation featuring Robert Whitfield MD discussing the growing interest in explant surgery alternatives, especially autologous fat transfer for breast augmentation. Speakers describe a mindset shift where patients and some surgeons previously did not see fat transfer as practical, emphasize the surgical learning curve (improvement with repetition over 10–15 years), and note practical transfer volumes (roughly 100–200 cc per side — ~one cup at 200 cc) and tradeoffs: fat transfer uses the patient’s own tissue and may present different long-term risks than implants. The clip also highlights that final size is a visual/patient choice and that small implants may carry exposure risk over time compared with fat transfer.
Questions this video answers
Robert Whitfield MD
November 11, 2025
100 to 200 cc per side
Roughly close to a cup size (per the speakers)
Chapters
The, the kind of, you know, shift in mindset, I guess, is the easiest way to say about, you know, people.
Are just not in alignment with that now. And they didn't understand that a fat.
Transfer was even a practical or possible alternative. Because if you.
From a surgical perspective, I did hundreds.
Of them every year for breast cancer patients. Right.
And that is not a common path.
So you wouldn't have that level of experience or repetition. And surgery for everybody listening is you get better at surgery with time. And, you know, your first 10 or 15 years after you finish, you're constantly improving and getting better because you're, you're doing and repeating a set of. Of skills and steps, and you get better at it. It's one of the few things where that happens. Yeah.
And so, like, when people say fat transfers that work, I'm like, really?
Okay, interesting.
Those are usually the folks who say.
That they tried hormonal therapy and it didn't work. And I'm like, man.
So if we take someone like Alexi and she has. She's a low BMI patient, but we take enough fat and we transfer it, whether it's. We'll say it's 100 to 200 cc's.
Per side, that's, you know, roughly, you.
Know, close to a cup size if it's 200 and then half if it's. And for her body type, maybe that's all she wants. And then that's.
That's great.
And then people ask me, well, is that a one and done?
Well, the. That's the patient's prerogative, not mine. Like, that decision, that's a visual thing.
That the patient wants. And then they used to have this discussion, Lexi, with patients who came from cosmetic breast augmentation. And if they asked me for a big implant, I would just simply tell.
Them no, because I didn't really.
It didn't align with me personally because I thought it looked bad.
So I would do it. Yeah. And if they wanted a super small.
Implant, I'd say, well, a fat transfer is better than that from a longevity standpoint, meaning that your exposure risk over.
Time is going to be more risky.
If you have an implant that's small.
Versus a fat transfer because it's your own tissue.
And so, like, there's this juxtaposition that.
People either, you know, a full explanation is what everybody wants to get an informed decision to make an informed decision. That that's, that's basically it. And I hear that they don't or never even knew those.
