Fat transfer after explant is not one to one

22 Oct 2026 · 1 min

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In this video, Dr. Robert Whitfield explains that fat grafting used after breast implant removal cannot replace the removed implant volume on a one‑to‑one basis. He notes that the density of fat differs from that of an implant and that fat is placed in a different anatomical plane—beneath the skin and above the breast tissue—rather than in the implant pocket. Dr. Whitfield then outlines the multiple patient‑specific factors that determine whether a breast lift is needed after explant, including nipple position, tissue volume and distribution, the size and position of the original implants, skin quality and stretch, pre‑existing asymmetries, prior surgical incisions, pregnancy or nursing history, and weight changes. These considerations guide his decision‑making for reconstructive or aesthetic outcomes after implant removal.

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Fat transfer in my practice has another role, which is adding volume back when we're taking volume out. So it's never going to be a one-to-one procedure. So if you're taking out a device of any amount, you're never going to typically put back that same amount of volume in fat, and it's not one-to-one anyway. The densities are very different and they do not go in the same places. Where you take an implant out of is a pocket created by placement of a device. That is never where I put fat back. Fat belongs beneath the skin, above the breast tissue, in the fatty layer. Now, what determines whether someone may want or need a lift after explant is obviously going to be different from case to case. We look at the nipple position, we look at the volume of tissues, the distribution, the size, and position of their existing implants. There are obviously skin quality, the stretch of the skin. Are there preexisting asymmetries side to side, which there normally are, either in volume or skin or breast or all of them? Any previous incisions, you know, skin stretch or looseness usually follow suit with pregnancies or nursing history or changes in weight. And those all have to be accounted for.