Simultaneous Implant Exchange with Fat (SIEF Surgery)

Over the last few decades millions of women have undergone breast augmentation or reconstruction with implants. Among them are a subgroup of patients that would rather remove their implants and not replace them:

- Those who have had excellent results and every 10 – 15 years replace them as recommended but as they age they would rather simply not have them anymore.

- Those who have had few revisions or complications such as capsular contracture and are tired of the long term commitment and maintenance of breast implants.

- Those who for any reasons are not candidates for breast reconstruction with implants.


Removing the breast implants is a relatively simple surgery; however, psychologically it can be taxing on the patient. Having large implants could have led to thinning of the soft tissue, some volume loss and stretched out and droopy skin over many years.

Recent advances in fat grafting science have revolutionized our approach to many challenging issues in plastic surgery. Simultaneous Implant Exchange with Fat (SIEF) is a relatively new procedure and a good alternatives to use your own fat and place it in the breast in the same surgery that your implants will be removed. This fat will be suctioned from areas such as abdomen, flanks, inner thighs and back. This fat transfer to breast can make up for the loss of implant volume and even in some cases enhance the volume.


Fat grafting is not as predictable as placing an implant with regards to final volume. Therefore patients may need multiple operations (liposuction and fat injection into the breast) to achieve their goal. Since SIEF is a new technique long term data is not available but successful case reports have been published in plastic surgery literature.

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