Simultaneous Implant Exchange with Fat, or SIEF, is a breast revision surgery in which breast implants are removed and then immediately replaced with the patient’s own fat. The fat transfer allows the breasts to maintain volume and shape — particularly upper pole fullness — without the need for new breast implants.
After breast augmentation, the breast skin may stretch in order to accommodate the size and shape of the implants. If the patient chooses to remove the implants in the future, breast volume loss and changes in breast shape may be noticeable. If the breast skin is still elastic, it may tighten naturally after implant removal; however, overly stretched or aging breast skin may appear depleted. Simultaneous Implant Exchange with Fat (SIEF) is an innovative technique that our Palm Beach plastic surgeons use to help patients who no longer want their breast implants, but who want to maintain breast volume, fullness, and shape.
During surgery, the areas from which the fat is to be harvested is infiltrated with a numbing solution, which also reduces the bruising (see the liposuction section for more information). The breast implants are then removed from the body and, if necessary, the intracapsular spaces which held the breast implants are cleansed.
The harvested fat is purified in a specific manner with a patented sterile device. The fat is then strategically re-injected into the breasts to achieve the desired shape, size, and fullness. Depending on the unique challenges your procedure might pose, your surgeon may vary the approach as needed to create an optimal outcome.
Your recovery after SIEF will depend upon the unique details of your surgery; however, you should expect some degree of post-surgical tenderness, bruising, and/or swelling. In addition to your breasts, the area(s) of your body treated with liposuction will be recovering as well, and temporary bruising and/or swelling is common. Compression garments will be required to promote proper healing where fat was removed, and your physician will advise you on how long these garments need to be worn. Recovery after liposuction typically takes about two to three weeks before patients can return to vigorous activity, but most patients are able to go back to work a week after the procedure.
The majority of patients who undergo SIEF are able to achieve a cup size that is slightly less than their augmented breast size with breast implants, or smaller if desired. For women who experience breast implant complications (i.e. capsular contracture and others that cause cosmetic abnormalities and/or discomfort) prior to SIEF, the natural-looking breast shape and feel they achieve after SIEF is often a tremendous relief and a boost to self-confidence. It is important to note that a certain percentage of the transferred fat is reabsorbed by the body during the healing process. This resorption process is accounted for during the initial procedure; however, occasionally patients who desire additional breast volume after the initial procedure may consider undergoing a second round of fat transfers six to twelve months later. To see SIEF before-and-after photos featuring our patients, we invite you to visit our photo gallery.
If you wish to remove your breast implants but do not want to sacrifice a full, shapely aesthetic, SIEF may be an ideal technique to achieve your goals. Contact our practice to learn more or to schedule a consultation with one of our plastic surgeons.