Hybrid Breast Augmentation (Motiva Mini 275cc + Condensed Rich Fat) + Liposuction of Inner Thighs and Cheeks + Thread Lift & Botox | 32-Year-Old Woman, 1 Month After Surgery
A 32-year-old woman. She wanted more volume in her bust and also wished to refine the fullness from her cheeks to her jawline, so we performed a hybrid breast augmentation combining a silicone implant with condensed rich fat, together with liposuction of the inner thighs as the fat donor site. On the same day, we also performed cheek liposuction, a jawline thread lift with 4 threads and 60 units of Botox to the masseters. The photos show her from the front and at an oblique angle before surgery and 1 month after surgery.
The short answer
This is a hybrid breast augmentation with a Motiva Mini 275cc implant and condensed rich fat (100ml on each side), combined with fat harvesting from the inner thighs and treatments around the face. The photos 1 month after surgery show roundness from the décolleté to the chest from the front, and more forward projection of the chest at an oblique angle.
Case overview
| Procedure | Hybrid breast augmentation (silicone implant + condensed rich fat grafting) / liposuction of the inner thighs and cheeks / jawline thread lift / Botox to the masseters |
|---|---|
| Details | Motiva Mini 275cc (axillary incision, subglandular) + condensed rich fat 100ml right, 100ml left (subcutaneous) / 300ml harvested from the inner thighs / cheek liposuction (small amount) / thread lift 4 threads / Botox 60 units (masseters) |
| Anesthesia / duration | General anaesthesia / about 1 hour 30 minutes |
| Photo timing | Before surgery and 1 month after surgery (front and oblique views) |
| Sessions | 1 session |
| Cost | JPY 1,457,200 (tax included, monitor price) Price list |
| Main risks | Swelling, bruising, pain, oedema, skin irregularity, asymmetry, scars, capsular contracture, rippling, lumps or calcification from fat grafting, palpable threads, etc. (details below) |
| Doctor | Dr. Shin Moriwaki (Director) |
Her concerns
She was bothered by the lack of thickness in her chest and the flat line from the décolleté to the breast, and also wished to refine the fullness from her cheeks to her jawline.
In slim patients, an implant alone tends to show its edges or a step, while fat alone is limited in how much volume can be added at once, so we proposed a hybrid breast augmentation combining both. The fat was harvested from the inner thighs.
Procedures performed
Hybrid breast augmentation (Motiva Mini 275cc + condensed rich fat)
After checking the width of her chest wall and the elasticity of her skin, we chose a Motiva Mini 275cc implant and inserted it in the subglandular plane through an axillary incision along the underarm crease.
From the fat harvested from the inner thighs, 250ml of purified fat was centrifuged (200 rpm for 1 minute) to produce 235ml of condensed rich fat, and 100ml was grafted subcutaneously on each side. We aimed to add subcutaneous thickness from the décolleté to the upper chest so that the edge of the implant is less visible.
Liposuction of the inner thighs (fat harvest)
300ml of fat for the breast augmentation was harvested from the inner thighs through small incisions in both groin areas.
Around the face (cheek liposuction, thread lift and Botox)
A small amount of cheek fat was removed through small incisions below both ears, and 4 threads were placed along the jawline to support the skin. 60 units of Botox were injected into the masseters.
Anaesthesia and operation time
The procedure was performed under general anaesthesia (propofol and midazolam) combined with nitrous oxide and sevoflurane, with 800ml of tumescent solution infiltrated into the inner thighs, 400ml into the chest and 100ml into the face. The operation took about 1 hour 30 minutes.
Changes from before surgery to 1 month after
Before surgery, there was little forward projection of the chest, with a flat line from the décolleté to the breast. In the front-view photo 1 month after surgery, roundness has formed from the décolleté to the chest, and the cleavage area has gained thickness.
At an oblique angle, the chest that was flat before surgery now projects forward, with a gentle slope from the décolleté to the top of the breast. The facial treatments are not shown in these photos.
Recovery and aftercare
Pain peaks 2–3 days after surgery and settles in about 10 days. Swelling and bruising gradually subside over 2–3 weeks.
Swelling and firmness of the breasts gradually settle over 1–3 months. Firmness in the liposuction areas (contracture) peaks around 1 month after surgery and usually settles in about 3 months, and any unevenness or discomfort from the thread lift usually settles in about 3 months.
A facial band is worn for 24 hours after surgery, and a breast band is worn from immediately after surgery for at least 2 weeks (ideally 1 month) to keep the implants from riding up. Sleeping face-down or positions that press on the chest should be avoided for 3 months, a non-wired bra should be worn for the first 1.5 months, and dieting should be avoided for 1.5 months to help the fat take.
These photos were taken 1 month after surgery, and the result will continue to settle gradually. The effect of Botox gradually wears off over time.
Risks and side effects
Liposuction may cause swelling, bruising, pain, oedema, skin irregularity or tightness, asymmetry, pigmentation and scars at the small incisions (both groin areas, below the ears, etc.). Rarely, complications such as infection, haematoma, numbness or reduced sensation may occur. Prolonged oedema or reduced sensation may occur in the inner thighs, and skin laxity, facial asymmetry or temporary difficulty moving the corners of the mouth may occur after cheek liposuction.
Silicone implants carry risks of capsular contracture, rupture or malposition of the implant, rippling (the implant's folds showing on the surface), infection and changes in nipple or breast sensation. Fat grafting may cause calcification, lumps or cysts, variable fat survival and asymmetry.
The thread lift may cause redness, swelling, bruising, dimpling or puckering of the skin, palpable threads and relapse, and Botox may cause an unnatural feeling when chewing or in facial expressions. General anaesthesia may temporarily cause nausea or throat discomfort.
These may occur during recovery and most ease over time, but the degree of symptoms and the length of recovery vary from person to person. If any symptom concerns you, please consult your surgeon rather than judging by yourself.
Free consultation available
1 min walk from Exit 6, Ginza-itchome Station / Open 10:00–19:00
The doctor in charge of this case
Shin Moriwaki, MD
Director, AVAN TOKYO Ginza Liposuction Clinic
Graduated from Tokushima University School of Medicine. Worked at Tokushima University Hospital, Tokyo Chuo Cosmetic Surgery and Gracia Clinic before taking up the current position. Over 5,000 liposuction procedures performed (including previous positions).
Member, Japan Society of Aesthetic Surgery (JSAS) / Member, American Academy of Aesthetic Medicine / ECFMG Certificate