Fat Injections for Breast Augmentation. The “Natural” Alternative.

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Fat injections have been used for a long time to rejuvenate the aging face by restoring it’s youthful volume, and to create some not-so-natural “volume” in the rear during a Brazilian Butt Lift. But (no pun intended), until recently, fat transfer to the breast has been reserved for breast reconstruction after cancer surgery.

As technology advances, the number of clinical applications for fat transfer procedures continues to rise. And since breast augmentation is the most popular cosmetic surgery in the country, some people are wondering whether breast implants are still the best for the bust.

Keep reading to learn more about the “natural” method of breast augmentation

How do Fat Injections work?

If you could only give Science credit for one thing, let it be the fact that someone figured out that fat can be transferred from one spot to another! Just imagine if you could snap your fingers and have less fat here, and more there? Well, that’s a reality nowadays, except that it takes a little more than a finger snap to get the job done.

Fat can be liposuctioned from a place where you have a little too much (tummy, hips, thighs, etc), and injected into a place where you have too little (sunken cheeks, deep links around your mouth, “no-junk-in-the-trunk booty”, etc). As long as the fat is handled gently, it will eventually grow new blood vessels in it’s new location and continue to survive.

It seems like a good idea, but why hasn’t it caught on for breast augmentation?

It’s not the “gold standard”

It is ‘catching on’, but only for some women. Breast implants are still the “gold standard” for breast augmentation, but for a select group of women who don’t want, or don’t believe in, a foreign-body breast implant, fat transfer is becoming a valid option. The procedure isn’t for everyone though, and it has several limitations that are keeping it from outing breast implants as the main method of breast enhancement.

Concerns over breast cancer surveillance

As you might imagine, there are concerns over breast cancer surveillance after fat injections, and this is keeping many doctors (and patients) from fully endorsing the procedure. In contrast to breast implant surgery in which the vast majority of the natural breast tissue is not surgically altered, fat transfer surgery does change the internal architecture of the breast. In addition, not all of the transferred fat survives, so as much as 50-60% of it is left to either be reabsorbed by the body, or form scar tissue. This makes it very tricky for radiologists to interpret mammograms, and for patients to interpret their own self-breast exams (click here to learn how to perform a proper self-breast exam).

Unpredictable results

Another reason why fat transfer breast augmentation isn’t mainstream yet is because the results can be somewhat variable, even in the most experienced hands. Because not all of the transferred fat survives, your surgeon has to use his or her best judgement on how much fat to inject. This means that your breasts will typically be over-augmented by as much as 50-60% during the initial surgery to compensate for the fact that about 50% won’t survive. This is not a hard fast rule however, so the final result can be unpredictable, especially compared to a breast implant which has a predetermined size that doesn’t change. Unpredictable results can mean more surgery, which is not the most attractive option for many women.

It can be a long procedure

The first fat transfer breast augmentations were reported to take up to 8 hours! That’s an awful lot of surgery for anyone, even a very young, very healthy patient. Anesthesia is a significant stress on the body, and anything that can be done to limit the amount of anesthesia that you receive, without compromising the result of the operation, is a good thing. Now that surgeons are more familiar with the fat transfer operation, it usually takes less than 8 hours, but it always lasts longer than the 1-2 hour implant procedure.

Los Angeles Plastic Surgeon Dr. Grant Stevens says, “In most cases, I can perform breast implant surgery in an hour or less, and get a fantastic result. This short procedure time helps my patients recover quicker and lessens their chances of having a complication related to anesthesia. I can certainly see the potential value in having fat transfer breast augmentation, but we first need to determine whether or not the risks of adding many hours onto the operative time outweigh the benefits of not having breast implants.”

Many women are not candidates for the procedure

Most women want two things… some junk in the trunk… and maybe some in the front too 🙂

Sorry ladies, but not everyone is a candidate for fat transfer procedures like the Brazilian Butt Lift or the Fat Transfer Breast Augmentation. We’re all very grateful that we know that fat can be moved from one place to another, but there’s gotta be enough fat to move!

The most commonly used breast implant is about 300cc (per side). That’s about 600cc of  implant that gets inserted. Finding 600cc of fat to liposuction on the women who want this size implant can be very difficult, if not impossible. Same goes for the booty… if you don’t have it, you’re not gonna get it!

“Size limitations are a major drawback with fat transfer for breast augmentation”, says Dr. Stevens.

Are Fat Injections “safer” than breast implants?

The words “safe” and “natural” are used almost interchangeably on websites that are heavily in favor of fat transfer for breast augmentation, but this is not necessarily an accurate statement. Fat transfer is “natural” in the sense that your own fat is used instead of an implant. However, as we discussed above, avoiding an implant comes at a price. Longer surgery with lots of anesthesia, and the possibility of needing repeat operations for unpredictable results, most certainly detracts from the safety profile of the operation. Not to say that the surgery is dangerous, because it’s not (at least not in the hands of a fully-trained plastic surgeon). But when compared to the stellar safety record of breast implant surgery, it’s very difficult to make a claim that fat transfer breast augmentation is safer.

Natural?… Yes. Safer?… probably not.

What’s the bottom line?

“The bottom line is that fat transfer for breast augmentation seems to be a viable alternative to breast implants in a very select group of women who don’t want an implant, don’t want a drastic size change, and aren’t very thin. But, it’s difficult to recommend the procedure with some of the unresolved concerns over breast cancer surveillance, and with the longer operative times.”, says Dr. Stevens. “It’s a relatively new procedure that still needs to be evaluated with good science. It’s years away from catching up to breast implant surgery as the ‘go-to’ method for breast augmentation, and I’m not entirely sure that it will ever catch up.”

Even if you’re not sure which procedure you want, click here to find out how to get the most bang for your buck with breast augmentation!

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Nicholas Vendemia, M.D.
Plastic Surgeon, New York City
MAS / Manhattan Aesthetic Surgery

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I want to thank Dr. Grant Stevens of Marina Plastic Surgery Associates for his input on this important topic. Dr. Stevens is a world-renowned expert in aesthetic breast surgery, and has been a great mentor and friend. Thank you Dr. Stevens.

Photo Credit: iStockphoto

NOTICE: None of the celebrities or individuals discussed here have ever received treatment, surgery, medical advice, or evaluations from any author, physician, surgeon, or representative of this blog. All images and photos in this article represent models only. No actual patients or clients are shown.


Filed under Breast Augmentation, Breast Exams, Breast Implants

5 responses to “Fat Injections for Breast Augmentation. The “Natural” Alternative.

  1. Cittypretty24

    What an interesting and informative article! I would love to see before and after pics. Are the results noticeable? Does the shape look ” lifted” like implants do? Also, how hard is it to fix any spits that lose volume?
    Thanks for the great info! Looking foward to your reply 🙂

    • MAS

      Hi CittyPretty!

      Thank you for your comment!

      The results are definitely “noticeable”, but they are modest. One of the main drawbacks of fat injections for breast augmentation is that you usually can’t get a major size increase, but for some women, this is fine.

      The procedure does not give as much of a “lift” as implants, and this is another drawback of the fat transfer procedure. If you have any sagging at all before surgery, chances are that you will be much happier with the look of an implant. In many cases, the additional volume available with implants, in conjunction with some internal modifications only possible through a real incision, will make a saggy breast perfectly perky 🙂 This isn’t possible with fat transfer.

      Thanks for reading, and writing!

  2. lynnNYC

    I had a natural breast augmentation a few years ago in Arizona. The surgeon was wonderful and my results were exactly what I hoped for – even better! I”m thin, so I actually gained 5 pounds before my surgery to make sure there was enough fat to lipo. This is a great alternative for a woman who wants to enhance their breasts but does not want implants. Just be sure to take your time and do research when looking for the best surgeon. THe reason this has had a bad rap is many surgeons do not do this procedure the right way!!!

    • MAS

      Hi LynnNYC!

      Thank you for your comment, and congratulations on your wonderful result!

      Also, thank you for pointing out the fact that it always an option to gain some weight if you’re intent on having a fat grafting procedure, but are otherwise too thin to be a candidate.

      The key point with fat grafting augmentation vs implants is that there are limitations to the procedure. Patients that will do the best with this procedure are women who want a very modest size increase, and who have nicely shaped youthful-appearing breasts to begin with. Women who want, or need, a great deal of volume, or those who have some sagging, won’t be happy with the results of this procedure. In addition, women who are unhappy with other features of their breasts not related to size (large areola, constricted breast, tubular breast, etc) will also do much better with a formal implant breast augmentation.

      I don’t necessarily agree that the procedure gets a bad rap because surgeons don’t do it correctly. First of all, it doesn’t truly have a “bad” rap at all. It’s a very well accepted procedure, but it has some major drawbacks that can’t be overlooked. Cancer surveillance is still a concern no matter what any surgeon says, and anyone who voices an opinion to the contrary is presenting just that… an opinion. There is currently no hard science to resolve that issue, but it’s definitely a work in progress. It’s going to take years of long term follow up to determine whether or not the procedure interferes with mammograms, self-breast exams, and the need for biopsies.

      Another drawback is that not many women are candidates, whereas anyone is a candidate for an implant breast augmentation. As we discussed above, only those women who want a very modest size increase, and otherwise have perfectly shaped symmetric breasts will get the maximal benefit from fat transfer. Without making a real incision, and without being able to utilize the wide range of implant sizes and shapes, there isn’t much that can be done for women with asymmetries and sagging, both of which are very common problems.

      The last major drawback is the extra anesthesia time. A well-trained surgeon with experience in breast augmentation can place breast implants in under an hour with a perfect result and an excellent safety record. It’s completely understandable why a woman would prefer not to have an implant if there was a “better” alternative, but since implants are so incredibly safe nowadays, it’s tough to make the claim that a much longer operation with occasionally unpredictable results and a complication rate that is the same is “better”.

      Your point about doing your research is very well taken, and very important. I would suggest taking it back one step and deciding whether or not you are a candidate for the procedure before you spend any time doing research or making appointments. If you want more than a cup size increase, if you have things other than size that bother you, if you are very thin, or if you have any sagging at all, chances are that you will be much happier with implants. If you are dead set against implants, make sure that you can accept the fact that the honest answer to the question “Does fat transfer make it more difficult to detect breast cancers?”… The answer is “We don’t know yet”.

      Thanks again for your comment LynnNYC! We’re really happy to hear that you got such a good result!

  3. ..........

    I read your comments and concerns. My experience has not been great. I went through the fat injections on my breasts and one year later, I developed cysts. Some were as little as a bb, and some as big as a marble. They were noticeable. I had lumps, and they were painful. I went to a specialists to get them removed (that was extremely painful). The reason I considered this was because i had four children and I didn’t have any stretch marks, so I figured this would work for me. I initially went for smart lipo body contouring, and the Dr. recommended, the injections. IT WAS A BIG MISTAKE. READ UP AND ASK AS MANY QUESTIONS, AS THIS IS OUR BODY…

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