Breast augmentation is a common procedure typically done using implants containing silicone gel or saline. However some women may be interested in breast augmentation using fat, otherwise know as fat transfer or fat grafting. This procedure uses autologous fat (your own fat), harvested with liposuction from typical areas such as abdomen, waist, or thighs, then injected into the breasts. Breast augmentation using fat remains much less common than implant augmentation. It also took a while for it to gain traction in the United States because of the litigious nature of our society and the fear that anything that obscured a mammogram could confuse or delay a breast cancer diagnosis. It is true that some calcifications can often be seen on mammogram after fat injection to the breasts, but radiologists are able to easily distinguish these from the calcifications typical of breast cancer. Breast augmentation using fat is also an option for women who have removed their implants, or undergone en bloc capsulectomy for breast implant illness. Fat transfer breast augmentation was originally promoted in the United States using the BRAVA system to prepare the breasts beforehand, but we now know that it can be done without using that. I do not use the BRAVA system. I am an advocate for hyperbaric oxygen therapy (HBOT) however, and I encourage my patients to combine a course of HBOT with their fat injection procedures.
How It’s Done
The aspirate that comes out with the liposuction is carefully separated, isolating the fat to be injected into the breasts. A rule of thumb is that half the volume of fat injected will stay permanently as living fat, while half the volume will go away during the healing process. The amount of fat that can be injected depends not only on how much fat can be harvested but also how the breast responds when it is being injected. Trying to force too much fat into the breasts at one time will cause problems including fat necrosis and excess loss of fat. So the size increase after surgery tends to be rather modest, one cup size at the most and likely less than that. To gain additional volume, a second or third procedure may be necessary. These procedures obviously can only be done if there is enough additional fat remaining to be harvested.
Costs of Breast Augmentation Using Fat
Some people expect that the procedure will be less expensive because implants do not need to be purchased. Unfortunately, the fat injection procedure takes longer than traditional breast augmentation and involves liposuction, and so it is actually more expensive. It can get even more expensive if a second or third fat injection procedure is necessary. HBOT is an additional expense.
Fat injection to the breast is also very useful in breast reconstruction or in women with traditional cosmetic breast augmentation, when contour defects or implant irregularities need improvement. In this procedure, the fat injected is a smaller amount, and is being used to supplement an existing breast implant rather than provide for an entire augmentation. Like with any fat injection procedure, multiple sessions might be necessary but again, the ultimate result tends to be permanent, since the fat is your own living tissue. It must be remembered that lean people are not good candidates for primary breast augmentation using fat, although small amount of fat harvested and transferred for contour improvements may still be possible. If there is nothing to harvest, there is nothing to inject!