Fat grafting to the breast is not a new technique and it can be dated to as early as 1895, Dr Czerny in Germany first transplanted a lipoma to the defects after breast tumor resection. The use of fat tissue to breast both for esthetic breast augmentation and reconstructive surgery had once aroused much controversy in plastic surgery society in quite a long time. In the past decade, fat grafting to breast has been proved to be a safe and effective procedure after numerous new techniques development and application. We recently develop a new protocol using fat grafts both for breast augmentation and breast defects correction and reconstruction. Large volume of fine microfat particles was harvested using a water-jet system and fat grafts were evenly injected into subcutaneous, subglandular, intramuscular and submuscular planes through different small incisions in the inferior mammary fold and around periareola using single-hole blunt tip cannulas with1.6- 2.0mm in diameter. Breast pre-expasion using a Brava system is also advised to those patients with small breast volume in order to increase the spaces and vascularity of the breast for better survive and take of the grafted fat tissue and reduction of complications such as mass, cyst and calcification formation. Fat grafting is also used to correct breast deformities and defects such as capsular contracture, rippling, irregularities and malposition of the implants, implant-fat replacement and breast reconstruction after tumor resection. The techniques were presented and the indications and contraindications were also discussed.

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