Hey, I'm just about two months out from fat transfer breast augmentation with Dr. Kevin Tehrani. Wanted to post some initial impressions here.

Who: Kevin Tehrani (NYC/Long Island) What: liposuction from abdomen/flanks, transfer to breasts

Why fat transfer: I've seen some really nice BAs with implants, but had concerns about safety (FDA recalls, etc.), aesthetics (wanted a more natural look), and long-term results (was not excited about replacing implants every 10-15 years).

Cost: generally higher than implants, however there are no subsequent procedures awaiting you when you inevitably need new implants later. I paid ~$15000, with another few thousand tacked on for aftercare: post-operative lymphatic massage, etc. Dr. Tehrani does not work directly with insurance companies. I believe I likely could have gotten this covered out-of-network, however I actually did not have insurance for the month I had surgery, due to losing my job.

Recovery: pretty painful for a week or so, I was on opiates. Pain is from the liposuction, not from the fat injection into the breasts. Breasts settle down very quickly. Liposuction recovery can last a long time—I still have some bumpy sections of my abdomen and flanks, and some soreness; this can take up to six months to fully resolve. And you need to wear a compression bodysuit over the liposucted area for 1-2 months afterwards, which gets very annoying. I also had a drain just above my groin for the first couple of days. Not for bleeding, but for this tumescent fluid they inject after the fat is liposucted to help with healing.

How does it look? Really good! I'm very bad at doing any kind of quantitative measuring, but my breasts are very noticeably larger. I don't think I've lost any volume so far, although perhaps it's too soon to say. But the breasts seem fully healed, so I'm not sure why I would lose anything at this point. Some folks experience necrosis of the injected fat, and I certainly haven't had anything like that. As for scars, there are four incisions along my abdomen, and one each under my breasts. They may fade to near-invisibility over time, they're pretty tiny as-is.

Some people dismiss fat transfer as not making enough of a difference. That's definitely not the case for me. That said, it's not the same as if I had gotten, you know, D cup implants or something. I believe Dr. Tehrani took around 1000 CC of fat out of my midsection, if that gives you some idea of what he was working with.

I also didn't even realize this when I was setting up my surgery, although in retrospect it's obvious, but taking a lot of fat out of your midsection and flanks is HIGHLY feminizing. I have ridiculous curves right now. I already had a big butt and big thighs though, it's worth noting. But I doubt I would ever have been able to reach this type of hourglass figure purely through exercise or weight loss. The fat has to come from somewhere, and if you pick the right spot, it can end up being extremely feminizing. After surgery, I immediately started getting hit on WAY more, and started passing much more frequently, both of which surprised me—I didn't realize moar boob would make such a big difference. But maybe that was naive of me, everybody loves tits.

How did I choose? I had consultations with a few different surgeons a couple of years ago. My top choice, Dana Khutaila, said no to me because I weighed a lot less at the time. Only two surgeons (Tehrani and Daniel DelVecchio) said yes to me, and DelVecchio seemed a bit shady to me. Since then, I gained a ton of pandemic weight, though, which I believe helped me have a better outcome. They don't recommend intentionally gaining weight for a procedure like this, but I kind of did try to do that anyway. I gained probably 15-20 pounds.

Tehrani has a significant presence on RealSelf, but not much of a focus on trans clients, and there aren't a ton of reviews of his breast fat transfer work. That said, he has been doing them at least 5-10 years, and he definitely does specialize in body contouring and liposuction, which is a huge part of a successful fat transfer to breasts operation.

He has a fairly good support system in place for post-op care—in-house massage therapists, etc.—however, there is extra cost for all that.

Overall I definitely recommend fat transfer if you can afford it, or if you can find a surgeon who works with insurance providers. And the more fat you have in non-feminizing places, the better your potential outcome.

Oh, one more thing, since there's a lot of info in the wiki about Brava: I bought a knock-off Brava system off eBay for like $150 or so and used it in the weeks before surgery. It's called "Bosom Beauty" if you search there.

Feel free to AMA, I tried to just kind of info-dump here so apologies if anything's unclear or difficult to follow.