Hybrid Breast Augmentation (Perle MR 255cc + Fat Grafting) with Upper Arm & Shoulder Liposuction | Woman in her 20s, 6 Months Post-Op2026.09.09
This case shows a woman in her 20s who underwent hybrid breast augmentation (silicone implant combined with fat grafting) together with liposuction of the upper arms and shoulders. The photographs were taken six months after surgery.
She came to us saying she wanted more volume in her breasts but did not want an obviously augmented, unnatural shape, and that she also wished to refine the fullness around her upper arms and shoulders. Because she is slender with limited breast tissue and subcutaneous fat, fat grafting alone would have made it difficult to achieve the size she wanted. An implant alone, on the other hand, can make the upper pole look conspicuous and may allow the edge of the implant to show. We therefore proposed hybrid breast augmentation, in which the implant provides the underlying volume and a layer of the patient’s own fat is placed over it.
We used a Perle MR 255cc implant, inserted through an incision in the axilla (armpit) and placed in the subglandular plane. Because the incision follows a natural crease of the armpit, the scar sits in an inconspicuous position. Compared with the submuscular plane, the subglandular plane involves less post-operative pain and allows the implant to move more naturally.
The fat was harvested from the upper arms and shoulders, the areas she had asked about. After centrifugation to remove impurities and fluid, 95 ml was grafted into the right breast and 85 ml into the left, distributed finely within the subcutaneous layer. Creating a layer of fat beneath the skin helps the line from the décolletage to the breast flow smoothly and makes the breast feel softer to the touch. The simultaneous liposuction of the upper arms and shoulders refined the roundness running from the outer arm to the shoulder. Being able to combine fat harvesting for augmentation with body contouring in a single procedure is one of the advantages of hybrid breast augmentation.
Six months after surgery, the grafted fat has settled and the implant has integrated with the surrounding tissue. A natural curve is visible from the upper pole to the lower pole, and the silhouette of the upper arms and shoulders is slimmer. Please note that swelling, bruising, fat survival rates, and the final shape and size of the breasts vary from person to person. For details, please consult a physician at an examination and counselling session.
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[Supervising Physician] Shin Moriwaki, MD
Member, Japan Society of Aesthetic Surgery (JSAS) / Member, American Academy of Aesthetic Medicine
ECFMG Certificate (U.S. medical licensure qualification)
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📍AVAN TOKYO GINZA LIPOSUCTION CLINIC
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