Breast Augmentation by Fat Transfer – Is It Right For Me?

Breast augmentation using your own fat is very different from breast augmentation using implants. With the current concerns regarding silicone breast implants, many women are turning to fat transfer as an all-natural method of breast augmentation. But the two methods could not be more different.

Breast implants are best if you want a large increase in size. This is because they are available in a wide range of sizes and you can, within reason, choose whatever size you like.  When they were first released onto the market, women usually selected implants with a volume of 150 or 175 cc. This equated to about a one cup size breast augmentation. Over the years, however, women have demanded ever increasing sizes, with many women choosing breast implants with a volume of 300, 400 and even 500 cc. These often look too large and unnatural.

Breast augmentation by fat transfer is more about improving the shape of the breast and restoring volume that has been lost, for example, following pregnancy. Usually between 100 and 200 cc of fat is grafted into each breast. This means that you can expect about a cup size increase in volume. However, the experienced surgeon will use this fat wisely and place it where it is most needed; for example, into the cleavage and the upper pole. The skin quality is greatly improved and most women love the fact that their breasts look and feel completely natural with a greatly enhanced cleavage.  Many women say that their breasts have been restored to how they were prior to their pregnancies. Fat transfer is an excellent way to improve the look of a bony chest, to correct a tubular breast and to correct breast asymmetry.

It is inevitable, however, that some women will be dissatisfied with their breast augmentation operation whether they have had implants or fat transfer. What are the common reasons for dissatisfaction?

With silicone implants, there are many causes of dissatisfaction and, for many surgeons, the revision rate is over 20% within the first two years. The reasons are that the implants may be sitting unequally (asymmetry), they may become hard due to capsule contracture, they may be visible under the skin (i.e. rippling) or they can leak. Sometimes fluid can form around a breast implant (seroma) and if your implants are of the textured variety, this is an early indicator of Anaplastic Large Cell Lymphoma (ALCL). Some women are just unhappy with their implant size and would like them changed for larger or smaller.

There are far fewer complications with breast augmentation by fat transfer. It is possible for a lump to develop due to fat necrosis but with an experienced surgeon this should be a rare event.  There may be some unevenness in the donor areas but these usually resolve by wearing a compression garment. The main cause of dissatisfaction is the desire for a larger size. Because breast augmentation by fat transfer is a biological, reconstructive procedure where living fat cells are transferred from one part of the body (e.g., the thighs and hips) to another (the breasts), the result will depend on how much fat can be transferred and how much survives and grows in your breasts. That is why the surgical technique and the post-operative care are so important.

It is important to realise, however, that there can be no absolute guarantee about the ultimate size of your breasts.  So if after a breast augmentation by fat transfer, you would like your breasts to be a little larger, then what can you do? The first thing we recommend is that you allow the breasts a little time to grow. It is usual for the breasts to increase in size over the first year or two as the living fat cells establish and grow. Some women choose to have a second transfer of fat into their breasts and we recommend that you wait at least 6 – 12 months before embarking on this option. Occasionally, a woman might decide that she wants her breasts to be much larger indeed and in these cases we recommend the insertion of a smooth-walled saline implant behind the muscle. The combination of a breast implant with fat transfer to the cleavage is known as a “hybrid” procedure and can give you the best of both worlds i.e., a breast size of your choosing together with the softness, skin quality and cleavage associated with fat transfer.

Another type of combined procedure is to do a breast lift with fat transfer. This provides a significant “auto-augmentation” and the procedure has far less risks than combining a breast lift with implants.

The trend these days for women with silicone implants, especially if they are textured, is to have their implants removed and replaced with their own fat. Most of these women, even though their breasts may be a little smaller after this procedure, feel a lot healthier and find that the slightly smaller breasts with enhanced cleavage and improved softness and skin quality are much more comfortable than their previous implants. And they appreciate the slimming of their hips, thighs or abdomen!

Obviously, if you are contemplating breast augmentation, it is important to speak with a surgeon who is familiar with all these options.