Welcome!
SIEF
(Simultaneous Implant Exchange with Fat Grafting)
Breast fat grafting uses autologous adipose tissue to refine contour, restore volume selectively and improve symmetry, emphasising anatomical support, tissue quality and long-term balance rather than relying on fixed implant volumes.​
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​My Approach
Many women choose to remove their breast implants - whether due to discomfort, capsular contracture, aesthetic changes, or simply a desire for a more natural feel. Simultaneous Implant Exchange with Fat Grafting (SIEF) replaces the implant with the patient’s own fat in the same operation, restoring shape and volume naturally without the need for new implants.
SIEF can also be used after breast reconstruction with implants, when patients experience implant-related issues or prefer a more natural long-term solution. By replacing the implant with one’s own tissue, SIEF offers a softer, warmer, and more natural result that continues to age harmoniously with the body.
Planning & Technique
During SIEF, the capsule surrounding the old implant is removed as completely as possible to restore a healthy, flexible pocket. In patients with symptoms such as discomfort, tightness, or systemic concerns attributed to their implants, a more extensive capsulectomy may be performed as part of a comprehensive management plan.
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Fat is then gently harvested from areas such as the abdomen or thighs, purified, and carefully grafted into the breast to recreate volume and contour. This method restores natural shape and improves comfort without introducing new implants.
Recovery & Expectations
Most patients resume light daily activities within a week or two. Swelling or mild bruising may occur around the liposuction and grafting sites, but typically subsides within two weeks. Light exercise can resume after three to four weeks, while more strenuous activity should wait until about six weeks.
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Support garments are recommended during recovery to help maintain shape as the tissues settle. The grafted fat gradually integrates over several months, resulting in a soft, natural contour that ages naturally with the body.
Complementary Procedures
SIEF can be combined with:
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Nanofat rejuvenation - to improve skin texture and tissue quality
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Liposuction - as part of overall body contouring, using harvested fat for both enhancement and balance
Post-operative care extends beyond routine reviews - it is an integral part of Dr Ng’s surgical philosophy. Through Doctor Stitch, an aftercare service founded to ensure seamless continuity and comfort, every patient is followed up personally by Dr Ng. Whether at home or in clinic, he provides attentive, discreet, and consistent care throughout the recovery journey.
Frequently Asked Questions
1. What is breast fat grafting?
Breast fat grafting is an autologous procedure where fat is harvested from another part of the body and carefully processed before being placed into specific breast regions to refine contour, improve transitions or restore selective volume.
2. How long do fat grafting results last?
Once integrated, fat grafting offers durable volume improvement because the transferred cells that survive become part of the tissue. Some degree of volume change is expected as the body adapts, but many patients experience lasting refinement.
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3. Does fat grafting affect nipple sensation?
In most cases, fat grafting alone does not significantly change nipple sensation because it is a soft tissue addition without major disruption to deeper innervation. Sensation should be discussed during planning, especially if combined with other procedures.
4. What are the limitations or risks of fat grafting?
Limitations include:
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modest volume change per session
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variable survival of grafted cells (usually about 50%)
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potential for irregular contour if overtreated or undercorrected
Risks are generally low but include bruising, swelling, under-graft survival and rarely oil cysts; careful technique mitigates these.
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5. Can fat grafting be repeated if needed?
Yes, repeat sessions are sometimes planned when incremental refinement or balance is desired. This is determined during follow-up and is part of tailored planning.
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Related Reading
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Treatment Options After Capsulectomy - for patients considering implant removal and natural reshaping
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Breast Reconstruction - for delayed or staged reconstruction after mastectomy
