Home/Breast Procedures/Simultaneous Implant Exchange with Fat (SIEF)

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.

What Can Simultaneous Implant Exchange with Fat Accomplish?

SIEF can be a very effective technique to retain breast volume and fullness even after implants are removed. The SIEF procedure can:

  • Be performed at the time of explantation or delayed until a later time
  • Be performed in combination with a breast lift
  • Correct aesthetic abnormalities caused by breast implant complications, such as wrinkling or rippling of the implant
  • Restore breast volume and shape with natural-looking results
  • Create breasts that are soft and more symmetrical
  • Even be performed at the time of breast augmentation in women with anticipated visible edging of the breast implant, called Composite Breast Augmentation.

As an added benefit, fat collection for transplantation is achieved with liposuction techniques, which creates a more slender appearance in the areas where fat is removed. Most commonly, liposuction is performed in the abdominal region, flanks, hips, thighs, or buttocks to obtain an adequate volume of fat to complete the SIEF procedure.

Candidates for Simultaneous Implant Exchange with Fat

Any woman who is in good health and has a sufficient amount of fat to complete the SIEF procedure may be a candidate for this technique. If you are considering removal of your breast implants and want to find out if SIEF is an option for you, we invite you to schedule a consultation with one of our physicians. During your appointment, your surgeon will thoroughly examine your breasts, assess the condition of your health, and discuss the reasons and goals you have for the procedure. Your doctor will also evaluate how much fat can be harvested from your body to accomplish the degree of augmentation you desire after implant removal. Finally, your surgeon will present you with the best surgical options for removing your implants and achieving the best results.

How is the SIEF Procedure Performed?

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.

What Can I Expect From Recovery After Simultaneous Implant Exchange with Fat?

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.

What are the Results of Simultaneous Implant Exchange with Fat?

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.