Sixteen years and two kids after having her first breast augmentation, Natalie Gilbert* discovered that one of her breasts had started to harden around its implant. She could also feel the implant’s edge, and there were divots and irregularities on both breasts, indicative of a somewhat common complication called capsular contracture. “[The implants] were really a mess. I knew they had to be taken out or replaced,” says Gilbert, 35, a New York-based professor of English.

To get the results she wanted—smaller, more natural-looking breasts, restored to their pre-baby perkiness—Gilbert’s plastic surgeon, Adam Kolker, MD, suggested something she didn’t even know was an option: a fat graft (aka fat transfer) into her breasts, along with new implants, to help create a softer look and feel.

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