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There are many ways to augment or enlarge the breasts.  By far the most common way is to place silicone or saline breast implants  (breast implantation, breast augmentation.)  However, fat can be transferred from other areas, such as the waist or abdomen, to the breasts for breast enlargement or breast augmentation.  Since fat is the patient’s own “natural” tissue, fat transfer to the breast has been termed “Natural Breast Augmentation,” or “Natural Breast Implantation.”   To fully understand the difference between breast implantation with silicone breast implants and breast augmentation with fat transfer to the breasts, it is important to read the section on breast augmentation (breast implantation.)

natural breast augmentation

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ADVANTAGES OF USING FAT FOR BREAST ENLARGEMENT:

The breasts can be enlarged using a patient’s fat.  The breasts consist mainly of fat and mammary glands.   By enlarging a breast with fat, the breasts become larger with the same tissue that they are made of, hence the term “Natural Breast Augmentation.”  The breasts will look and feel very natural.  The other advantage of using fat, it that the areas from which the fat was harvested will be improved.   Usually we harvest the fat from the waist and abdomen, but we can use anywhere where the patient chooses as long as there is enough fat.  The patient gets improvement in each area from which we harvest the fat, usually a narrower abdomen and waist, and larger breasts.  Multiple areas are improved with this surgery.  A major advantage of fat transfer is that the overall figure, not just the breasts, are improved.   Another advantage is that is takes only 2 tiny little poke holes to inject the fat, so there are no scars.   Breast augmentation with implants always requires and incision which leaves a small scar (please see the previous chapter on breast augmentation.)

DISADVANTAGES OF FAT TRANSFER TO THE BREASTS:

As the fat is transferred to the breasts, the skin of the breasts fills up similar to a balloon that is inflating.  At some point the skin will be completely tight and cannot hold any more fat.  At this point no more fat can be injected.   Not all of the fat lives.  Usually only 30% to 60%, of the transferred fat will live, and so the breasts will shrink back a little.  Because of this, fat transfer works best in women who have been pregnant because their skin was stretched out from the pregnancy and their skin envelope can hold more fat.  As a general rule of thumb, fat transfer to the breast can only enlarge the breast one cup size.  Therefore fat transfer will not work well in a patient with A-cup sized breasts who has never had a child and wants anything more than a small B cup.  For the patient who wants more than one cup size enlargement,  silicone or saline breast implants (breast implantation,) are a much better option.  Another major disadvantage of “natural breast augmentation,” is that the patient must have some fat to transfer.  Obviously fat transfer will not work in a very skinny patient with no fat to transfer to her breasts.

Unfortunately fat transfer to the breasts costs more than routine breast augmentation, but more than one area is improved.   Natural breast augmentation improves more than just the breast it improves the entire figure.

Fat transfer surgery takes much longer than routine breast implant surgery.   This is because the fat must be harvested with liposuction, spun down and purified, and then injected into the breasts.  Usually this takes about 2.5 to 3 hours.  Breast implant surgery usually takes only about 45 minutes to an hour.   Because it takes longer to perform natural breast augmentation, it costs more.  However, the areas from which the fat is harvested are improved.  So this means not only do the breasts look better, but other areas get better as well.   So even though the cost is more, actually it is more economical to have natural breast augmentation because it improves more areas.  For example if the fat is harvested from the waist, and abdomen, both of those areas will be liposuctioned and look much better.

IF FAT CAN ENLARGE THE BREASTS, WHY ARE IMPLANTS STILL THE MOST COMMON WAY TO ENLARGE THE BREATS?

Breast implants have a much greater ability to enlarge and shape the breasts than fat.  Fat can enlarge the breast at most one cup size or slightly more.  If a patient wants more than one cup size enlargement, they must have a breast implant. Another disadvantage of fat transfer, is that the fat cannot shape the breasts as well as a breast implant. Also, routine breast augmentation with implants costs less than fat transfer to the breasts.

FAT RESORPTION:

After fat transfer, not all of the transferred fat lives.  On average, only about 50% of the transferred fat will live.  Most of the fat that is going to die, will do so in the first 2 weeks, but some fat is still dying up to 4 to 6 weeks after surgery.  Usually most of the fat that remains after 6 weeks is permanent.  The amount of fat that lives is partly due to how gentle the patient is with the breasts.  If the patient is very gentle with the breasts early after surgery sometimes as much as 65 or 70% of the fat can live.  If the patient sleeps on the breasts or traumatizes the breasts sometimes only 30% will live.  It is important not to touch, manipulate, press on, sleep on, or squish the breasts.  The more gentle the patient is with the breasts early after surgery, the more successful the surgery will be.

NATURAL BREAST AUGMENTATION CANNOT BE PERFORMED IN A SMOKER:

Smoking hurts the blood supply to the surgical areas. This kills the fragile newly transferred fat cells and most will die making the surgery a waste of money for the patient. For this reason, we will not perform fat transfer on any patient who is a smoker.

WHAT IF I WANT MY BREASTS TO BE LARGER AFTER FAT TRANSFER TO BREASTS?

For patients who want their breasts to be larger, a second fat transfer can be performed once the patient has completely healed from the first surgery. This can only be done if the patient has enough fat to transfer. The patient can also have a routine breast augmentation with implants if she desired.

WHAT HAPPENS IF I LOSE WEIGHT, WON'T THE FAT GO AWAY?

After we are fully grown, the number and distribution of fat cells we have is relatively constant (some fat cells are slowly lost throughout life as we age.) This means we don’t gain any fat cells if we get fatter, and we don’t lose any fat cells if we get thinner.  The fat cells we have simply expand if we gain weight and shrink if we loose weight.  This means if we put more fat cells in the breasts, the breasts will always have more fat cells.  The breasts will always be larger than they were prior to the fat transfer to the breasts.  If a patient gains weight, the breasts will enlarge more quickly because they have more fat cells and if a patient looses wait, the breasts will shrink more slowly.

HOW THE PROCEDURE IS PERFORMED:

Natural breast augmentation (fat transfer to the breasts,) is usually performed under general anesthesia.   First the fat is harvested using the standard liposuction technique (see the chapter on liposuction.)   The fat can be taken from any area the patient wants to improve.  Usually Dr. Smith takes the fat from the waist and abdomen, but sometimes additional areas are needed as well.   Once the fat has been harvested it is spun down in a centrifuge and purified.  The purified fat is then injected into the breasts with a special needle through one or two tiny poke holes which are not visible.  We inject as much fat as we can until the skin is stretched tight and the fat starts to squirt back out of the injection holes. Once this occurs we stop.  The patient is placed in a special compression garment for the liposuctioned areas, and special bra for the breasts. The surgery usually takes 2 to 3 hours to perform.

WHAT TO EXPECT IN TERMS OF RECOVERY AND HEALING:

Usually the recovery from natural breast augmentation is similar to the recovery from liposuction surgery. The patient will be sore in each area from which we harvested the fat, and less sore in the breasts. Most patients can return to work after 5 to7 days as long as they do not do anything strenuous at work. If work is strenuous patients should wait 3 to 4 weeks prior to returning to work.  Patients may usually return to light exercise after 4 weeks, and heavy exercise after 6 weeks. Patients can expect to be bruised, but usually the bruising will be gone after a week. The breasts will be swollen and shrink slightly for several weeks, after about 5 to 7 weeks, the breasts will be close to their final size.

THE RISKS OF NATURAL BREAST AUGMENTATION SURGERY:

Like most cosmetic surgeries, natural breast augmentation is a fairly safe surgery with generally small risks. The vast majority of patients are extremely happy with their surgeries and feel it is one of the best investments they have ever made.  However, like all surgeries there are risks and it is important to be informed of them.  The risks of all surgeries include pain, bruising, swelling, need for more procedures, damage to surrounding structures, infection, anesthetic risks, poor cosmetic and poor functional result. The additional risks of fat transfer include lumpiness and waviness.

Dr. Smith, a board-certified surgeon, does among the most fat transfer surgery in the Western United States. Fat transfer is one of the most common procedures Dr. Smith performs. He is considered one of the top surgeons for this procedure. If you want to learn more about “Natural Breast Augmentation,” (fat transfer to the breasts,) or Breast Augmentation (breast Implantation,)  please make an appointment at our office by calling 702-838-2455 or email us at info@smithsurgery.com.