Breast Surgery with Lipofilling

posted on | updated on | by Zuri Girl

As women, we have a love and loathe relationship with our bodies, especially after years of weight fluctuations, having children and breastfeeding. The beautiful, healthy human we created is worth every ounce of deflation…but after much consideration, and many desperate attempts to get your boobs to look pretty again in a blouse (let alone in the nude!), some women decide to research surgical options. Breast augmentation conjures up many mixed thoughts…but what about re-filling your former breasts with your own natural fat…not implants?

Klinik Tiefenbrunnen

One of our girlfriends was brave enough to book this procedure for herself…and after begging her to share her story (because honestly, her boobs look so good!) she agreed. Here is what she had to say:

“I first met Dr. Gmür over a year ago after needing some scar rehabilitation to reduce the unsightly red and raised appearance of a cesarean scar that was not healing well and developing a keloid appearance. After routine injections and witnessing his meticulous skill with a needle, the scar began to heal beautifully and in the comfort of the examination room, I asked him questions about his surgical experience, favorite procedures, and typical patient. He told me that he developed an interest to specialize in Lipofilling Fat Transfer and studied under the pioneers of the procedure in the United States. Dr. Gmür is one of the few cosmetic surgeons in Switzerland to offer “breast augmentation with autologous fat transplantation” and after asking to see some before and after photos of his work…it was time to stop dreaming and book a date with the surgeon.”

After seeing how happy our girlfriend was with her results, we asked Dr. Gmür if he had time for an interview so we could learn more about him and this procedure. It turns out, he is one of the top cosmetic surgeons who specializes in Lipofilling is based right here in Zurich. Dr. Gmür is partner at Klinik Tiefenbrunnen, a private cosmetic surgery center with its own well-appointed examination, operating and recovery rooms overlooking the Lake Zurich, complete with some of the most friendly and professional nursing staff.

GGZ: Who is the ideal candidate for this surgery?
Dr. Gmür: The candidates who benefit most from Lipofilling of the Breast are women who have completed breastfeeding and want to replace some of the lost volume, but do not want silicone implants. There is also the group of average women who have not had children, but would like larger breasts. This procedure is safe and very effective in both cases.

GGZ: How is the surgery performed?
Dr. Gmür: I divide the surgery into two parts. First, we begin with liposuction to harvest your natural fat, and second we do the lipofilling. The liposuction is performed a bit softer than if the removed fat cells were not going to be used again. We extract the vital fat cells…what I like to call the ‘Liquid Gold’ using very small diameter cannulas using low negative pressure suction techniques. The removed fat is stored in a closed system with no risk of contamination or desiccation so the cells are healthy. Once enough volume for filling of the breast is removed from the body, I prepare the fat for insertion into the breast and pectoral muscles using an even smaller cannula.

GGZ: Do you often combine a breast lift with this procedure?
Dr. Gmür: If the patient wants or needs a breast lift, this is discussed before the surgery. In many cases, the fat transfer gives the breast enough volume to provide a natural lift. There are some occasions when the patient gives me the freedom to decide during surgery after the filling is complete if a lift is still needed. There are times when we complete everything in one surgery, or we plan to stage the procedure into an additional surgery to achieve optimal results, particularly if the patient has a small breast cup to begin with.

GGZ: Is it possible to achieve a nice result with just the fat transfer, or is an implant recommended?
Dr. Gmür: At present, most women in Europe are preferring just the fat transfer, whereas in the US, there is trend towards a combination of a smaller implant with a fat transfer, as the additional layer of natural fat helps hide the edge of the implant and prevents the ‘rippling’ effect. My preference is to avoid the use of an implant for a very natural looking and beautiful result.

GGZ: What percentage of fat cells survive on average?
Dr. Gmür: Up to 80% of the healthy fat cells survive the transfer, if done properly. In theory, about half of the existing breast volume can positively accept new fat, if you add more, you will only lose more of your fat grafts. Therefore in my experience the same amount of fat transferred into a larger breast takes better than if injected into a smaller breast (for example, someone who has not breastfed). To further augment the grafting capacity of the breast, I also add fat to the muscle behind the breast because there is a greater amount of blood flow within the muscle, ensuring the survival rate of the fat grafted to that area.

GGZ: What can you expect post-operation?
Dr. Gmür: There will be bruising, swelling and pain predominantly on the liposuction sites for 2-4 weeks following the surgery. It is important to massage the cream that is provided to you post-surgery onto the areas that have been liposuctioned and to wear the compression garments under your clothing. Some women are able to return to work after 4-5 days of recovery and depending on what you wear, no one will know that you had surgery!

GGZ: How long before final results are visible?
Dr. Gmür: The results will be visible to you once swelling is gone after 4 weeks, your breast will continue to heal though over the next 8 weeks since your body needs time to get rid of the cells that didn’t survive the process of fat grafting I like to adhere to a 3 month waiting period to see the final results, as up to 20% of the fat injected does not survive. I have found that 50% of my patients request a second session because although they are very happy with the results from the first session, they wish to re-graft additional fat for optimal results.

GGZ: Could you please share with us your background and training in this procedure?
Dr. Gmür: I am a Board Certified Plastic Surgeon since 2002. After my formal training here in Switzerland I have completed different specialty training courses in Dallas, TX; Beverly Hills, CA; and Miami, FL. I first became interested in fat transplants in the early 90’s when it became a global trend under the pioneer Dr. Sydney Coleman from New York, and then Dr. Roger Khouri advanced the scientific research and development of the procedure towards the breast. I have dedicated my practice to focus specifically on breast fat grafting, where I follow the methods of these pioneers which have continued to show beautiful results through the years. I am also leading workshops in lipofilling techniques for surgeons from Switzerland and abroad.

In summary, our girlfriend also wanted to share from her own personal experience:

“It is important to understand that cosmetic surgery is a very personal decision and results are not always consistent from one individual to another. Fortunately, in my case, the results were truly exceptional. Dr. Gmür is an artist and sculpted my sadly deflated breasts into a beautifully full, round and symmetrical result…all without the use of an implant. Even all the nurses working came over to view the final result and compliment his work! (Apologies, I am not willing to share personal photos online with Girlfriend Guide…the photos in this article are of other patients, but if you would like to speak with me directly email the ladies at Girlfriend Guide  and they will put you in touch with me for more details)

For any readers curious about the surgery, but unsure how to manage with children…Have daddy take the kids for a weekend getaway. It was not easy, but possible to manage returning home and healing alone for 3 days in a quiet house with meals pre-prepped in the refrigerator and painkillers by your side. If you really need to, ask a friend to check in on you.

After the second day, the pain was indeed very intense and it was good to just rest on the sofa, watch movies and sleep all day; however, just 4 days post surgery, enough courage was gathered to accept a dinner invitation with a friend. With some loose clothing, painkillers, and a big smile…neither she, nor her husband seemed to notice anything was different. In this case, the goal of the surgery was not to increase cup size, as I was a D-cup before breastfeeding and just wanted to fill-up my pretty bras again. For anyone with a smaller breast, Dr. Gmür would increase cup size as well. 

It is true, 20% of the initial volume seemed to disappear approximately 8 weeks post surgery, and when I went running after 12 weeks, there was still a slight tingling feeling in the legs (healing of the nerve endings) where liposuction was administered. Regarding the liposuction itself, Dr. Gmür removed only what was needed for the fat grafting…so at the end of the day, it did not feel like I “lost a lot of weight” as most of it was added back into the body…just redistributed…a dream come true!

On the topic of a second surgery, it is understandable why 50% of his patients decided to do it again, because from my experience, the full and swollen breasts you see post surgery are truly GORGEOUS and once swelling goes down, you could see the opportunity to achieve that body again with a second surgery since the entire experience was very manageable and rewarding.”

For more information, book a private consultation with Dr. Gmür. If your consultation is scheduled during the months of May, June, July and August 2017, he will generously waive the his fee of CHF 160, just mention you read this article when you meet with him.


Klinik Tiefenbrunnen
Dr. Med. Roger Gmür
Website . Tel: +41 44 397 1717