Nowadays autologous fat transplant represents an effective cell therapy, due to the fact that a fraction of the lipoaspirate consists of adipose-derived adult stem cells. In this study we retrospectively report the two-year experience of 41 patients treated with autologous fat transplant to repair different breast- related problems. A postoperatively 3 months interval follow-up was performed in association to imaging follow-up, using ultrasound as first step. According to the grading scale, we report the results assisted by the plastic surgeons and the patients. A total of 68 breasts were treated in 65 operations. 38 patients were treated unilaterally and 15 patients bilaterally. In the follow- up we evaluate the clinical outcome using a grading scale consisted of 5 crescent grades, from 1 to 5, based on the patient's satisfaction and on the clinical evidence of the achievement of the desired target. A percentage of 70.7% are classified with a grade over 3. Among 12 patients, one developed small liponecrotic lesion. We confirm that placing small aliquots of fat in the recipient site strongly reduce the phenomenon of liponecrosis on sonography. Thus, our experience confirms that this procedure is an easy, safe, effective and reliable surgical procedure also in the breast.