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Fat grafting — how it works

Your own fat,
serving your breast

Breast fat grafting uses only your own tissue — no foreign material. Fat is harvested by liposuction, centrifuged to isolate viable fat cells, then reinjected as micro-droplets through multiple passes to maximise graft take.

The technique is well-established in breast reconstructive surgery and recognised as highly effective by the international scientific community. It is endorsed by the French Society of Plastic, Reconstructive and Aesthetic Surgery (SOF.CPRE).

Fat is harvested atraumatically through small incisions hidden in natural skin folds, using a fine aspiration cannula. The harvested fat is then centrifuged to separate intact, viable fat cells from non-graftable elements (serosities, oil). The fat is then reinjected in micro-droplets across multiple independent tissue planes, creating a three-dimensional network that maximises contact between the grafted cells and the recipient tissue.

The grafted fat is a living graft: fat cells that become revascularised will survive permanently. Graft take is estimated at 60 to 70%, which means a slight overcorrection is performed initially to account for partial resorption.

Important: Fat grafting cannot cause breast cancer. However, it will not prevent cancer from developing if it was going to occur. Regular breast surveillance is maintained after every procedure.

60–70%
Fat graft take rate
Fat cells that become revascularised survive permanently. Partial resorption justifies a slight overcorrection and sometimes multiple sessions.
2 years
Delay after breast-conserving treatment
After breast-conserving treatment: at least 2 years after the end of radiotherapy.

After mastectomy: often shorter — depends on cancer type and adjuvant treatments, assessed case by case.
1–6
Sessions — sometimes more
Sessions are spaced 3 to 4 months apart. Number depends on the volume to correct and the graft take rate. There is no limit.
Two main indications

Who is breast fat grafting
indicated for?

Fat grafting addresses two distinct situations, both related to breast cancer treatment: correcting sequelae after breast-conserving surgery, or reconstructing / improving the breast after total mastectomy.

After breast-conserving treatment
Following lumpectomy + radiotherapy: localised hollow, shape or volume asymmetry, scar retraction, irradiated skin changes, décolleté deformity. Occurs in 15–20% of cases.
After mastectomy
Essential adjunct to implant or flap reconstruction (fill a hollow, improve irradiated skin, correct asymmetry), or standalone reconstruction by progressive sessions for small volumes.
Improvement of skin quality
Injected fat lastingly improves the quality of irradiated skin: increased suppleness, reduction of brown discolouration, improvement of telangiectasias. Recognised trophic effect on tissues.
Breast-conserving treatment sequelae — detail

Deformities that fat grafting can correct

Localised hollow in the décolletéDepressed area over the scar or excision site — difficult to correct by any means other than fat grafting.
Breast asymmetryDifference in shape or volume between the two breasts following surgery and radiotherapy.
Scar retractionScar that adheres to deeper tissues and pulls on surrounding structures, creating induration and tethering.
Post-radiation skin changesHardened, discoloured skin, telangiectasias. Fat grafting durably improves skin trophicity.
Nipple-areola complex deformityMisdirection or retraction of the areola and nipple due to scar traction.
Overall volume lossSignificant volume reduction after removal of a large tumour from a small breast.
How the procedure works

What happens during
fat grafting?

The procedure is performed under general anaesthesia, as a day-case — no overnight stay — at the Hartmann Clinic in Neuilly-sur-Seine. It consists of two stages: fat harvesting by liposuction, then reinjection into the breast.

01
Mapping & harvesting
Donor sites are selected (abdomen, thighs, flanks, saddlebags). Fat is harvested through small incisions hidden in natural skin folds, via a fine aspiration cannula. The harvested fat is immediately centrifuged.
02
Centrifugation
Centrifugation separates intact, graftable fat cells from non-graftable elements (serosities, oil, blood). Only the pure cellular fraction is kept for transfer.
03
3D micro-injection
Fat is reinjected as micro-droplets through fine micro-cannulas, along multiple independent planes — creating a three-dimensional network that maximises contact surface and graft take.
04
Controlled overcorrection
A slight overcorrection is performed to account for partial resorption (30–50%). If the result is insufficient, a second session is possible 3–4 months later.

Before the procedure: pre-operative assessment

A reference breast imaging assessment is systematically performed before the procedure by a radiologist specialising in breast imaging. It includes mammography, ultrasound and MRI if needed. The same radiologist will perform the 1-year follow-up imaging, repeated at 2 and 3 years.

Fat grafting is not performed if the disease is active or if radiological images are difficult to interpret. Each case is discussed individually.

Complete smoking cessation is required at least 1 month before the procedure — smoking significantly increases the risk of complications.

No aspirin or anti-inflammatory drugs in the 15 days before the procedure.

Anaesthesia & setting

General anaesthesia. Day-case procedure — no overnight stay. Discharge on the same day.

Duration

40 minutes to 1h15 depending on the volume to be treated and the number of donor sites.

Coverage

Covered by French Health Insurance (Assurance Maladie) in the context of breast cancer sequelae and breast reconstruction. Dr Zeitoun practises in secteur 2 — additional fees apply. A detailed quote is provided before any procedure.

Number of sessions

1 to 6 sessions, sometimes more, spaced 3 to 4 months apart. There is no limit to the number of sessions.

Post-operative

Recovery
and results

Recovery is generally straightforward. Most of the discomfort comes from the liposuction donor sites, not from the breast injections.

The first days

Moderate painMainly at the donor sites (hips, abdomen), well controlled with standard pain relief.
Swelling and bruisingOedema at the operated sites: takes 3–4 months to fully resolve. Bruising at donor sites: resolves in 10–20 days.
FatigueOne to two weeks, especially after significant harvesting.
No sun exposureAvoid exposing operated areas to sun or UV for at least 4 weeks — risk of permanent pigmentation.

The result

Initial results become visible at 1 month. The definitive result — once swelling has resolved and fat cells have stabilised — is assessed at 3 to 6 months.

Long-term, positive effects on irradiated skin quality are notable: improved suppleness, reduction of brown discolouration, partial reduction of telangiectasias.

Body contour is also improved by liposuction of the donor sites (hips, abdomen, thighs).

Result stability depends on weight stability. The grafted fat is living tissue and will change with your weight: significant weight loss may reduce the volume gained.

Result assessed at 3–6 months Lasting skin quality improvement Body contour improved by liposuction
Oncological safety

Fat grafting and breast cancer:
what the science says

The oncological safety of fat grafting after breast cancer has been the subject of extensive research. The current scientific consensus is clear and reassuring.

Fat grafting does not cause cancer

Fat grafting will not prevent cancer from developing if one were going to occur. Regular breast surveillance is therefore maintained with the same rigour after the procedure.

Calcifications do not pose a diagnostic problem

Calcifications that may appear after fat grafting are different from those seen in breast cancers and do not cause diagnostic difficulties for a radiologist experienced in breast imaging.

Rigorous pre-operative imaging is mandatory

A strict imaging assessment (mammography, ultrasound, MRI if needed) is performed before the procedure by a specialist breast radiologist. The same radiologist will carry out the follow-up at 1, 2 and 3 years. Fat grafting is not performed when the disease is active.

Timing depends on the treatment received

After breast-conserving treatment, fat grafting is typically performed at least two years after the end of radiotherapy. After mastectomy, the delay is often shorter — it depends on the type of initial cancer and is assessed individually during consultation.

Frequently asked questions

Your questions about
breast fat grafting

Fat grafting
What is the difference between lipofilling, lipomodelling and fat grafting?

These three terms describe the same technique: autologous fat transfer. Lipofilling and lipomodelling are commonly used in Europe. Fat grafting or fat transfer are the usual English-language terms. All refer to exactly the same surgical procedure.

Same technique, different names
Result
Is the result of breast fat grafting permanent?

The fat that takes (60–70% of what is injected) is living and permanent: revascularised fat cells survive as long as the surrounding tissue. The technique is therefore definitive for the fraction that has taken.

However, the result is not entirely stable over time: it changes with your weight. Significant weight loss may reduce the volume gained; weight gain may increase breast volume. Maintaining a stable weight is therefore recommended.

Permanent for the fraction taken Weight stability recommended
Coverage
Is breast fat grafting covered by French health insurance?

Yes, in both main indications — sequelae after breast-conserving treatment and breast reconstruction after mastectomy — the procedure is covered by the French Health Insurance (Assurance Maladie) on the basis of the standard rate, under the long-term illness scheme (ALD).

Dr Zeitoun practises in secteur 2 (private sector) with fees above the standard rate, including for patients covered by the ALD scheme. A detailed, transparent quote is provided before any procedure. Your complementary health insurance may cover part of the additional fees.

French Health Insurance (ALD) Additional fees — systematic quote provided
Donor fat
What if I am very slim and have little fat to harvest?

The available fat capital is assessed during the consultation. If the volume available is insufficient to achieve the desired result in a single session, multiple sessions spaced 3 to 4 months apart can add volumes progressively.

For large volumes to reconstruct — particularly after mastectomy in very slim patients — fat grafting alone may be insufficient, and a combination with another reconstruction technique (implant, DIEP flap) is then discussed.

Fat capital assessed in consultation Multiple sessions possible if needed
Mammography
Can I continue breast surveillance after fat grafting?

Yes. Breast imaging surveillance is maintained after fat grafting with the same rigour as before. A reference imaging assessment is performed 1 year after the procedure, ideally by the same radiologist who carried out the pre-operative assessment, to enable reliable comparison.

Calcifications that may appear after fat grafting are different from those seen in breast cancers and do not cause diagnostic problems for an experienced breast radiologist.

Breast surveillance maintained Reference imaging at 1 year
Return to activities
When can I return to work and normal activities?

Return to sedentary work is possible after 1 to 2 weeks. For physical work, allow 2 to 3 additional weeks. Driving is possible once pain allows.

Light physical activity (walking) is encouraged early. Sports involving the donor sites (core work, swimming) and the injected areas should be avoided for 6 to 8 weeks. Return to all activities is confirmed at the post-operative check-up.

Sedentary work: 1–2 weeks Sport: 6–8 weeks depending on the areas

See also

Let's discuss your situation

Whether you are dealing with sequelae after breast-conserving treatment or looking to improve your reconstruction — a consultation will determine the options best suited to your case. Appointments available within one week.

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Fees & Reimbursement

Transparent pricing

Dr Zeitoun practises in the French private sector (secteur 2 non OPTAM) with fees above the standard Sécurité Sociale rate. The standard rate is reimbursed by French Health Insurance — with enhanced coverage for cancer patients (ALD) — but does not cover additional fees. Your complementary health insurance may cover part or all of these additional fees depending on your policy.

Additional fees (dépassements d'honoraires)
Dr Zeitoun charges fees above the standard rate — including for patients covered by the ALD scheme. A detailed quote is always provided before any procedure. No quote is issued without a prior consultation.
Complementary health insurance
Your complementary health insurance may cover part or all of the additional fees depending on your policy. We recommend checking with your insurer beforehand.
FREN