Hybrid Breast Augmentation (Motiva Demi 225cc) + Inner and Front Thigh Liposuction | 20-Year-Old Woman, 3 Months After Surgery
A 20-year-old woman. She wanted more volume in her breasts, so we performed hybrid breast augmentation combining a silicone implant with fat grafting. The fat for grafting was harvested from the inner and front thighs by liposuction with ultrasound assistance (LSSA). The photos show her upper body from an oblique front view before surgery and 3 months after surgery.
The short answer
This case combines hybrid breast augmentation using a Motiva Demi 225cc implant and fat grafting (120ml on the right, 110ml on the left) with liposuction of the inner and front thighs. In the photos 3 months after surgery, the area from the décolleté to the breasts, which was flat before surgery, now has a rounded fullness, and there is a cleavage in the centre of the chest.
Case overview
| Procedure | Hybrid breast augmentation (silicone implant + fat grafting) / liposuction of the inner and front thighs (ultrasound-assisted) |
|---|---|
| Details | Motiva Demi 225cc (axillary incision, subglandular) + fat grafting 120ml right, 110ml left (subcutaneous and subglandular) / fat removed 400ml (inner and front thighs) |
| Anesthesia / duration | General anaesthesia / about 1 hour |
| Photo timing | Before and 3 months after surgery (oblique front view) |
| Sessions | 1 session |
| Cost | JPY 1,396,000 (tax included, monitor price) Price list |
| Main risks | Swelling, bruising, pain, oedema, skin irregularity, asymmetry, scars, capsular contracture, rippling, fat lumps and calcification, firmness of the thighs due to induration, etc. (see below) |
| Doctor | Dr. Shin Moriwaki (Director) |
Her concerns
She had little breast projection and was bothered by the flat line from her décolleté to her chest.
In slim patients, an implant alone tends to show its outline or a step, while fat alone is limited in how much volume can be added at once, so we suggested hybrid breast augmentation combining both. The fat for grafting was harvested from the inner and front thighs.
The procedures
Hybrid breast augmentation (Motiva Demi 225cc + fat grafting)
After checking the width of her chest wall and the stretch of her skin, we chose a Motiva Demi 225cc implant and placed it in the subglandular plane through an incision along the armpit crease.
From the 400ml of fat removed from the thighs we prepared the fat for grafting and injected a total of 120ml on the right (100ml subcutaneous, 20ml subglandular) and 110ml on the left (100ml subcutaneous, 10ml subglandular). The aim was to add thickness under the skin from the décolleté to the upper breast so that the implant edge is less visible and the slope looks natural.
Liposuction of the inner and front thighs (fat harvesting, ultrasound-assisted)
The inner and front thighs were treated as one continuous area. The ultrasound device (LSSA) softens the fat before it is removed with the cannula, which makes it easier to reduce the thickness evenly over a wide area and reduces the step at the border that tends to appear when only part of an area is treated.
The fat removed was 400ml. The small incisions are in the armpits (for implant insertion), at the front of the armpits, below the nipples and in the groin.
Anaesthesia and operating time
Surgery was performed under general anaesthesia (propofol) with nitrous oxide and sevoflurane, and tumescent solution was injected: 1,000ml into the thighs and 800ml into the breasts. The operating time was about 1 hour.
Changes from before surgery to 3 months after
Before surgery she had little forward projection, with a flat line from the décolleté to the chest. In the photos 3 months after surgery, there is a gentle fullness from the décolleté to the breasts, a cleavage has formed in the centre of the chest, and the breasts have a rounded shape down to the lower pole.
The timing and posture of the photos differ before and after surgery. These photos mainly compare the breasts; changes in the thighs are not compared 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.
Firmness in the thighs where fat was removed (induration) peaks around 1 month after surgery and usually settles in about 3 months. Tightness and firmness of the breasts also gradually soften over 1–3 months.
After surgery she wore a compression garment for the thighs (girdle) 24 hours a day for 1 week. Sleeping face down or postures that press on the chest should be avoided for 3 months, and a non-wired bra should be worn until 1.5 months after surgery. Short, lukewarm showers are allowed from the next day; baths, saunas and strenuous exercise from 2 weeks after surgery.
These photos were taken 3 months after surgery.
Risks and side effects
Liposuction may cause swelling, bruising, pain, oedema, skin irregularity or tightness, asymmetry, pigmentation and scars at the small incisions (groin, etc.). Rarely, complications such as infection, haematoma, numbness or reduced sensation may occur. In the thighs, temporary firmness and irregularity due to induration may occur, and swelling may last longer.
With silicone implants, capsular contracture, implant rupture or malposition, rippling (the implant's wrinkles showing on the surface), infection and changes in nipple or breast sensation may occur. With fat grafting, calcification, lumps or cysts, individual differences in fat survival and asymmetry may occur. General anaesthesia may temporarily cause nausea or throat discomfort.
These symptoms may occur during recovery and most improve over time, but their severity and the time to recover 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).
Certifications
・VASER Lipo certified physician
・ECFMG Certificate
Memberships
・Member, Japan Society of Aesthetic Surgery (JSAS)
・Full member, Japanese Society for Regenerative Medicine
・Member, American Academy of Aesthetic Medicine