Is it better to do a fat transfer to breast than implants?

Doctor Answers 8

Fat Transfer vs. Implants

The answer to this question depends on which patient we are talking about. Some patients are better candidates for fat grafting whereas other patients are better candidates for implants. In general, most patients with small breasts do better with implants than fat grafting. This is because there is a limited amount of fat that can be placed safely into each breast in one session whereas with implants the size can be accurately preselected before surgery. In addition, studies have shown that fat grafting for primary breast augmentation (as opposed to fat grafting in combination with a breast lift) is more effective when preoperative suctioning of the breasts is performed for many weeks using a device called the Brava. Wearing the Brava for multiple hours a day is uncomfortable and a significant hassle for many patients and as a result, very few patients are willing to perform the necessary preoperative regimen to allow for the most successful fat grafting.

On the other hand, patients who already have a fair amount of breast tissue, but need more fullness in the upper breast and need a lift at the same time are often good candidates for fat grafting.  In these patients, they do not need a significant amount of additional volume, but just selective filling in the upper breast and the option of fat grafting is great because they can get the fullness they need with relatively low maintenance and low risks.

Santa Monica Plastic Surgeon
5.0 out of 5 stars 39 reviews

Fat transfers better than implants?

Fat transfers is just a natural option for breast enlargement and that may be a better option for some patients (but not all).  Patient expectations, patient selection (based on what a patient has to work with) and extensive experience with good surgical technique by your surgeon are all factors that will have an impact on the success of breast lipoaugmentation.  

There is no procedure that is ideal for everyone. Every procedure has advantages and disadvantages. The best procedure in the wrong hands or selected for the wrong patient will always result in unhappy patients. There are limitations in what fat transfers can do such as the maximum volume that can be achieved per transfer session (usually not more than one cup size). Unless you are willing to maybe have to do more than one session to achieve more than one cup size, then the procedure is not for you. Also it may cause some lumpiness (but so can implants) but in more experienced hands and for patients who are better candidates, there is less chance of this. Not all surgeons have the same type of experience or have the same hands or use the same techniques so choosing the right surgeon who knows not only how to safely perform the procedure but who also knows how to select the proper patient is very important. Being a good candidate is also important. If you have more good quality fat to give, if you have more breast tissue to begin with and if your breast skin is not too tight, then you would be a better candidate. Also having the right expectations is key. If you are wanting to be 2 cup sizes bigger and are not open to having to possibly do more than one fat transfer session, then you should give serious consideration for breast implants. If you choose fat transfers to the breasts in place of implants, you would be able to avoid inherent risks of implants such as rupture, capsular contracture, rippling, wrinkling and migration of implants.

Getting a consultation from some reputable board certified plastic surgeons who have a lot of experience doing this is a good place to start to see if this is a good option for you.

Best wishes.

Is it better to do a fat transfer to breast than implants?

You will get different answers from different surgeons.

My opinion is that implants give you more reliable and larger augmentation than fat grafting. Fat grafting is still new and very long term results are not yet documented. Loss of volume after fat grafting is common.

If you chose fat grafting please see a very experienced board certified plastic surgeon.

Breast enlargement with fat grafts or implants?

The two procedures are quite different in expectations and associated risks.  Fat grafting can be repeated and under ideal circumstances may result in a half cup size enlargement.  This doesn't satisfy most patients but for some undergoing liposuction it is appealing.  For those who wish a significant augmentation, the best results will predictably occur with placement of breast implants.  Implants don't last lifelong however and although modern implants are quite safe and durable, still have risks and future need of additional surgery such as replacement.
Meet with an ABPS Bd Certified plastic surgeon to determine what procedure will best address your needs and meet your goals.  Good luck and enjoy!

Jon A Perlman MD FACS
Certified, Am Board of Plastic Surgery
Member, Am. Society for Aesthetic Plastic Surgery (ASAPS)
Beverly Hills, Ca

Jon A. Perlman, MD
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 29 reviews

Is fat grafting to the breasts better than implants?

Thank you for your excellent question.  Breast implants offer a safe, reliable, and predictable result when trying to increase the size of a woman's breasts and is performed far more commonly than fat grafting.  That said if you are interested in only a small increase in breast size and are hesitant about implants, fat grafting may be a better option for you.  See a board certified plastic surgeon in consultation, they can best discuss your treatment options and offer you the best recommendation.  Best wishes!

Nelson Castillo, MD
Atlanta Plastic Surgeon
5.0 out of 5 stars 38 reviews

Fat or breast implants

This depends on how big you want to become.I ofte times remove implants and replace them with fat but not all of the fat that is transplanted will take.I also do what I call a composite aug ie I use a silicone implant and enhance the cosmetic results with fat grafting.So that may be a better choice for you.

Robert Brueck, MD
Fort Myers Plastic Surgeon
5.0 out of 5 stars 54 reviews

Is it better to do a fat transfer to breast than implants?

According to postings by patients on RealSelf, a higher percentage of patients felt that that an augmentation using breast implants was better than fat transfer to the breast

While it is possible to do fat injections to the breast as a cosmetic augmentation, currently, it is felt that only up to 50 of transplanted fat successfully survives in its new location. The remainder doesn’t go elsewhere. It is just resorbed by the body. Fat injections to the breasts may be useful in making small modifications and correcting asymmetries, but many plastic surgeons feel this procedure is not as reliable or predictable as an augmentation with breast implants.

The concerns: Long term results do not yet exist, like any procedure there are potential risks including infection, oily cyst formation, mammographic changes which can be confused with breast tumors, asymmetry, the results are not totally predictable and are inconsistent as compared to breast implants which are the most extensively tested and FDA approved medical devices with a lengthy record of safety and efficacy, it is a lengthier procedure, more costly, may require additional sessions of fat injection, and to optimize the results usually requires a prolonged use of an external device called BRAVA which is uncomfortable and has a poor record of patient acceptance and compliance.

There are an increasing number of satisfactory reports of this procedure being performed, but there are still a wealth of additional unresolved issues: The extent of resorption of the fat, the large volume of fat that is required to produce an improvement, the limitation of the amount of the very modest augmentation that is possible (usually only up to ½ or one cup size), and specifically a concern about long term safety with regard to tumor stimulation, which all need to be further investigated with valid scientific studies before fat injection should be viewed as a standard procedure for cosmetic breast augmentation.

Keep in mind that following the advice from a surgeon on this or any other website who proposes to tell you what to do without examining you, physically feeling the tissue, assessing your desired outcome, taking a full medical history, and discussing the pros and cons of each operative procedure would not be in your best interest. I would suggest you find a plastic surgeon certified by the American Board of Plastic Surgery and ideally a member of the American Society for Aesthetic Plastic Surgery (ASAPS) that you trust and are comfortable with. You should discuss your concerns with that surgeon in person.

Robert Singer, MD FACS

La Jolla, California

Robert Singer, MD
La Jolla Plastic Surgeon
4.6 out of 5 stars 19 reviews

Fat transfer vs breast implants

Hello and thank you for the question.This is become a very hot topic recently. Many women still undergo breast augmentation every day. Fat transfer has gained in popularity over the last several years specifically the Brazilian buttlift type procedure.When considering fat transfer vs. Breast implants fat transfer has the benefit of being your own body's natural tissue. It combines two operations at one time with a combination of liposuction as well as fat transfer. In terms of natural feel it will commonly feel more natural than a breast implant since it is your own body's tissues.The disadvantages of fat transfer to the breast are number one some of the fat does not survive the transfer. So in the end you might only wind up with 60% or even 50% of the original fat that was injected. There's a certain degree of unpredictability in terms of where the fat is absorbed and where does it survive further it is impossible to determine if the right breast has more fat survive in the left breast and vice versa.  Lastly  fat transfer to the breast typically can only achieve a small to modest increase in breast size.  you will not achieve the same type of fullness and enlargement that you can typically get from breast implantsThe advantage of a breast implant is that the results are very predictable and consistent. Generally speaking you are able to achieve a larger and Fuller volume with breast implants then you can achieve typically with fat transfer. Although breast implants do not last forever their long-term history shows excellent implant longevity often into the decades and all of the manufacturers all offer a lifetime warranty on the implants.The disadvantage of breast implants is the possibility of implant infection rupture or capsular contracture which is a inflammatory reaction around the implant that causes the implants to become hard and firm and sometimes painful. That can be a difficult problem to correct.The simple answer is the followingIf you were looking for a significant increase in size and perkiness and want a One procedure option and are not interested in liposuction then go with a breast implantsIf you are looking for only a very modest increase in breast size and have some excess fat that you would like to have liposuction and do not mind the possibility of needing a touch-up procedure done to achieve better symmetry or restore some of the fat that was lost in the transfer then you should consider that as an optionAs always it is best for you to see a plastic surgeon in your area have several consultations and then make a decision.Best to you 

Bennett Yang, MD
Rockville Plastic Surgeon
4.9 out of 5 stars 10 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.