Some people like the idea of having bigger breasts, but they don’t like the idea of breast implants. Breast augmentation with fat is technically known as autologous breast enlargement. This procedure uses your own fat instead of implants to increase breast size. Fat is liposuctioned from another area of the body and injected into the breast.
According to the Aesthetic Society, more than 22,000 people received autologous breast augmentation (also called breast fat grafting) in 2021.
The main advantage of this type of augmentation is that there is no implant, so the breast feels more natural. Also, this type of surgery tends to have fewer complications. On the other hand, the disadvantages include cup size limitations, the inability to lift a sagging breast, and potential problems with future breast screening.
This article explores the benefits and drawbacks of autologous breast augmentation.
Illustrated by Joules Garcia for Verywell Health
About the Process
In the past, the American Society of Plastic Surgeons (ASPS) did not recommend the use of fat for breast augmentation. In 1987, the ASPS said the side effects could make screening for breast cancer more difficult. Side effects of autologous augmentation may include:
- Thick or hard lumps
- Sebaceous cysts, which are growths filled with liquid fat
- Calcifications, which are bone-like spots
- Contamination
- Fat necrosiswhich is the death of fat cells due to lack of oxygen
At that time plastic surgeons stopped doing the procedure. More recently, the ASPS Fat Graft Task Force stated that the procedure may be useful in some cases.
The procedure is also called ‘stem cell breast augmentation’. This label is misleading. A stem cell can develop into different types of tissue depending on where it is placed in the body. Fat contains stem cells. However, stem cells alone cannot be injected into the breast to increase breast size. They must be combined with fat.
Before deciding to have this procedure, it is important to understand the potential long-term effects of breast fat transfer.
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No standard technique
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Magnifies only one cup size
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A breast lift may still be needed
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Fat can be reabsorbed
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Calcifications can affect breast cancer imaging
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It should have enough fat to carry
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Fat necrosis (small hard masses that look like cancer) can be permanent
Advantages
During the procedure, fat is suctioned from another part of the body and injected into the breasts.
Benefits include:
- No implant needed
- Breasts look and feel normal
- A small incision (the incisions made to remove and re-inject the fat are only 4mm long)
- Benefits for slightly damaged breasts
- Good success rate
- Most people are happy with the results
The procedure has a good track record when used to augment healthy breasts. It has fewer complications than implant surgery. And fewer people end up needing another operation later.
Case reviews have found that most people and their doctors are happy with the results. And for people who have had breast surgery to treat cancer, studies have shown that autologous augmentation does not increase the risk of the cancer coming back.
Disadvantages
However, there are some disadvantages to autologous breast augmentation. Surgeons have published detailed descriptions of how to remove and inject fat to increase breast size. But there is no standard technique for the process.
For this reason, you will want to find a surgeon with a successful track record with this procedure. It is also important to know what the process can and cannot do.
Other disadvantages include:
- Cup size restriction
- Can’t lift loose breasts
- Fat injection can make breast cancer difficult to detect
- You may not have enough excess fat for the procedure
- You must be self-motivated
With autologous augmentation, your breasts will only increase by about one cup size. This is because the tissue expander (a fat pocket) only supports a limited amount of fat. So at most, an A-cup breast will grow to a B-cup. With breast implants, there is no such limitation.
Your surgeon may rely on you to administer an external dilator before the procedure. Self-motivated people tend to do better, especially with self-directed expansion.
Because the fat does not have its own blood supply to keep it alive, it uses the blood supply already present in the breast. Therefore, a limited amount of fat can be injected.
If too much fat is injected, it will be reabsorbed. This means that the breast size can shrink again. Unfortunately, it is also possible for the fat to harden.
In addition, not everyone has enough extra fat for this process. To effectively increase breast size, the surgeon must harvest at least 1,000 milliliters of pure fat.
Fat transfer vs. implants
Fat transfer is only one type of breast augmentation. Other methods include:
- Saline breast implants: These implants are filled with sterile water and are FDA approved for people over 18 years of age.
- Structured saline implants: These have an internal structure, which makes them feel more like natural breast tissue.
- Silicone breast implants: These implants are filled with silicone gel that looks more like natural breast tissue. They are FDA approved for people over 22 years of age.
- Gummy bear breast implants: A type of silicone implant that is thicker and firmer and maintains its shape even when the shell breaks.
- Round breast implants: They are the same shape all over, which limits their ability to roll out of place. They tend to feel softer and have more natural movement.
- Textured breast implants: These implants rely on scar tissue that adheres to the implant, making it less likely that the implant will move out of place. They are no longer used in the US because of their link to cancer.
While breast implants offer greater size and lift options, they do come with some risks. According to the US Food and Drug Administration (FDA), implants can cause desensitizing breast pain, and you run the risk of breast implants rupturing or deflating. In some cases, you may have trouble breastfeeding after getting implants. In addition, breast implants—mostly textured—are associated with a type of non-Hodgkin’s lymphoma (BIA-ALCL).
How much?
Like all procedures, the price of autologous breast augmentation varies depending on your condition, where you live and the surgeon you choose. However, the average cost is around $10,000.
Summary
Autologous breast augmentation is a procedure that increases breast size by injecting your own body fat into the breast. The procedure usually works well and has few complications.
The process has many advantages. First, it uses your own body fat instead of an implant. It also requires very small incisions and the breasts usually look and feel natural.
There are some downsides to consider. One is that your breasts will only be one cup bigger. Another is that you may still want a breast lift because fat injection will not tighten loose breast skin. Calcifications are also likely to form, which can complicate breast cancer screening down the road.
Not everyone is a good candidate for this procedure. You may want to discuss other options with your plastic surgeon if you have very little body fat.
