{"id":15900,"date":"2021-03-16T13:59:15","date_gmt":"2021-03-16T20:59:15","guid":{"rendered":"https://www.realself.com\/news\/?p=15900"},"modified":"2023-10-17T16:06:37","modified_gmt":"2023-10-17T23:06:37","slug":"how-to-make-breasts-bigger-without-implants","status":"publish","type":"post","link":"https://www.realself.com\/news\/how-to-make-breasts-bigger-without-implants","title":{"rendered":"Wondering How to Make Your Breasts Bigger Without Implants? Top Surgeons Share the Ins and Outs of Fat Transfer"},"content":{"rendered":"

This article has been medically reviewed for accuracy by Lutherville, MD board-certified plastic surgeon Dr. Ricardo L. Rodriguez<\/a> on September 2, 2020.<\/em><\/p>

Seeing an aesthetic procedure all over social media can breed a strange sort of FOMO. (Hey, we’re not immune.) Yet it may be difficult to distinguish for-the-’Gram fads from truly “Worth It” tweaks. Which is why we’re launching a new series on RealSelf: <\/em>Everybody’s Doing It<\/em><\/a>. Each month, we’ll explore all sides of an of-the-moment cosmetic procedure, to bring you the uncensored truth about its efficacy and safety so you can decide if it’s right for you. Here, in our latest installment, we’re covering fat transfer breast augmentation.<\/em><\/em><\/p>

It’s been dubbed the “natural boob job,” “implant-free breast augmentation,” and “minimally invasive breast enhancement”—names ripe with modern-day appeal, aiming to encapsulate what’s medically known as fat transfer to the breast<\/a>. But the growing interest in this cosmetic surgery procedure—and, make no mistake, it is<\/em> a surgical procedure—is being propelled by more than just clever marketing. <\/p>

In recent years, the classic boob job has come under fire as a certain type of textured surface breast implant has been linked to a rare non-Hodgkin’s lymphoma called BIA-ALCL<\/a>.  A more nebulous condition known as breast implant illness<\/a> (BII) has also been reported, but a clear evidence based understanding of what it is has not emerged. Of course, implants also pose more standard risks, like rupture and capsular contracture, in addition to requiring lifelong surveillance.<\/p>

Despite these drawbacks, traditional breast augmentation<\/a> with silicone or saline implants remains the most popular plastic surgery procedure in America, according to a 2019 statistics report<\/a> from The Aesthetic Society<\/a>. While the operation has, in fact, held the number-one spot since 2008<\/a>, its numbers took a bit of a hit recently, dropping 15% between 2018 and 2019. In that same span, the demand for breast implant removal<\/a>, or explant surgery, jumped by nearly 35%.<\/p>

Interested in breast fat transfer?<\/small><\/div>Find Doctors Near You<\/a><\/div>

The recent rise of fat transfer to the breast<\/h2>

Fat transfer, via liposuction, to the breast has not always had a good reputation. In 1987 the American Society of Plastic Surgeons (ASPS) published a position paper advising against fat grafting to the breast. With the advent of more refined and safe fat grafting techniques pioneered by S. Coleman MD , fat grafting experienced a renaissance. Significantly, the ASPS reversed its position in 2007, and since then fat grafting has gained mind share with board-certified plastic surgeons, reporting a 37.3% spike since 2015. “About three years ago, we started seeing an increase in patients asking for fat grafting alone for breast augmentation to avoid implants,” says Beverly Hills, California, board-certified plastic surgeon Dr. Kelly Killeen<\/a>. Before that time, she adds, many had never heard of fat grafting to the breast. “Now that’s specifically what they’re coming in to consult about.”<\/p>

Board-certified Beverly Hills, California, plastic surgeon Dr. Sheila Nazarian<\/a> attributes the uptick to both fear of BII and patients’ desire for a more natural appearance using their own fat. In many parts of the country, plastic surgeons report, women have been requesting smaller cup sizes for at least the past five years. And fat grafting lends itself well to modest gains, notes Dr. Ashley Gordon<\/a>, a board-certified plastic surgeon in Austin, Texas.<\/p>

In Seattle, board-certified plastic surgeon Dr. Lisa Sowder<\/a> has also noticed a heightened interest in fat grafting to the breast, which she’s been performing for more than nine years. “It’s a popular breast augmentation procedure for both BII and non-BII patients who’ve explanted and want some volume restoration,” she says. While she concedes that many women’s breasts bounce back nicely post-explant without any intervention, certain patients—particularly those whose already thin breast tissue has been damaged by implants or the explantation process—can benefit from a little extra padding in certain spots. “I do fat transfer for maybe 1 in 15 of my explant patients—most of them don’t really need it,” she adds.<\/p>

Not every surgeon is a fan of adding fat to the breasts, however, and not every patient is a candidate. Moreover, the procedure comes with its own set of risks and limitations. Successful fat grafting is an technique-dependent procedure. The way the fat graft is processed impacts both fat graft survival and the rate of complications. Ahead, we answer your most pressing questions about creating cleavage, enhancing lifts, and rebuilding and revising breasts with fat.<\/p>

Fat grafting 101: How can I get a breast augmentation without implants?<\/h2>

Plastic surgeons can indeed make your breasts bigger without implants, using a two-step technique that involves liposuctioning areas of the body with excess fat—the belly, hips, flanks, and other exercise-resistant zones—and subsequently relocating that body fat, once purified, to the breasts.<\/p>

Of course, this is a serious oversimplification of what experts know to be a painstaking and nuanced undertaking. “You have to be very gentle with the fat, with minimal handling and manipulation when you harvest it,” says Dr. Sowder, alluding to the removal and processing of the fat. The grafting process should be approached with an equal measure of care. “My goal is to weave the fat throughout the breast tissue in an even way, injecting tiny amounts with each pass,” says Dr. Killeen. “When we do it in that manner, the fat is more likely to get a blood vessel and to stay and live there permanently. <\/p>

Depositing pea-size parcels of fat as opposed to one big blob not only gives the entirety of the fat bundle the best shot at picking up blood supply and surviving long term, but it also encourages stability, notes Dr. Sowder, since tinier blebs are more easily supported by the surrounding tissue.<\/p>

Depending on where the fat is placed, it can enlarge the whole of the breast or deliver a more customized effect by rounding out select sections. “The upper pole is often targeted, because that’s where volume loss typically occurs—especially with breastfeeding, weight loss, and implant removal,” notes Dr. Sowder. (Bear in mind, she adds: The shrinkage seen with volume loss is not the same as sagging. When a breast deflates, its nipple usually maintains a reasonable position; when it droops, the nipple shifts downward toward the floor, and a breast lift<\/a> is generally indicated.)<\/p>

Here’s the thing though: Because fat lacks structure, it can’t give the round, projected shape that many breast augmentation patients desire. “If you want the look of a perky breast, you need an implant,” says Dr. Killeen. What’s more, fat isn’t powered to make you more than a cup size or so bigger. “A pretty significant percentage of breast augmentation patients want to be two cup sizes larger—and that’s just not obtainable with a single round of fat grafting,” she adds. “Really, the person who does the best [with fat transfer] already has a decent shape and is just looking for a step up in breast volume.”<\/p>

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🙂🙂🙂My last post about fat transfer to the breast prompted a lot of questions, which I think this video answers well. I love fat grafting as a tool. And, for some women, it is the right choice. However, for the goals that *most* patients are aiming for, an implant remains the gold standard. The key here is that your surgeon has an open, honest discussion with you detailing all of the pros and cons of each option, and all risks involved. Implants have risks, fat transfer has risks, it’s all about what is right for you.👍🏻👍🏻👍🏻 call 610-356-6100 for a consult, or email chelsea@drsubbio.com, or submit an inquiry through the website link in bio. If you’re looking to do a procedure anytime soon, I would highly suggest calling now, as frankly, it seems like there has been a pent-up demand for surgery over quarantine and the summer book is filling rapidly.🤓<\/a><\/p>

A post shared by ♠️plastik surjon♠️<\/a> (@dr.subbio) on