Thank you for your question Ashley,
It can be a major decision to get breast augmentation, and many want to have natural looks and proceed with natural options before taking on artificial means, not to mention, undergoing surgery.
However, after childbearing, and breastfeeding, the breasts lose volume, and you cannot get the same breast size as before without using a breast implant. There is no natural option that can increase breast size and a surgery is the only way to give back the previous fullness. Don't bet scammed by creams and pills that for only $9.99 will do magic.
An in-person exam and consultation with a board-certified plastic surgeon is necessary in order to determine if the breast lift would be needed.
Although a surgery is needed, a natural option does exist for breast augmentation. It is called breast fat transfer, but it can only increase the breast size by ½-1 cup.
There is accumulating data that fat transfer, when properly performed, is as safe. Below is some information about it.
Fat transfer to the breast involves carefully harvesting fat using liposuction from areas in which you have excess, unwanted, and stubborn fat deposits such as the outer thighs and abdomen, flanks, hips, etc., and injecting it safely back into the breasts which may be lacking in aesthetics or volume.
Below I describe the pros and cons of the fat-based breast augmentation.
- Fat is usually inexpensive, abundant, readily available and accessible, and can be harvested numerous times
- Fat is your own tissue, and your body will not reject the transplanted tissue
- There is no foreign tissue reaction as seen with implants – i.e., Capsular Contracture
- Your body figure is improved by removal of fat while your breasts are enhanced
- The procedure results in soft and natural breasts with long-lasting results
- It is minimally invasive and your recovery will be quick
- It can be used to enhance the cleavage area, improve symmetry, and change the shape of narrow based breasts
- It is a scarless procedure
- Fat transfer to the breast will also improve the skin quality overlying the breasts through a rejuvenation effect (i.e., repair sun damage)
- There is a limit to the augmentation size possible with fat
- Unlike implants where you can choose the size you want, you can only go up by a maximum of 1 cup (e.g., ½ - 1 cup increase in breast volume) – If you want to go for a C cup, only an implant can be used
- You may require more than one procedure to get the desired effect for 2 reasons: 1) you can only put a limited amount of fat in the breasts at a time, 2) fat reabsorption can occur resulting in reduced volume
- In case a retreatment is needed, it can only be done 3-6 months later to avoid death of fat tissue
- Procedure is not possible if you do not have enough fat available for transfer from donor sites
- It cannot correct the nipple position, or correct sagging of breasts (ptosis)
- It does not provide the upper pole fullness that can be achieved with an implant.
Please find a board-certified plastic surgeon who is an expert in fat transfer and share your goals with them.
Now, I am assuming that you are concerned over the safety of silicone implants.
The best way to make an informed decision is to know pros and cons about the option. I describe some below.
Silicone Implants (5th generation silicone breast implants)
Silicone as a filler will make the implant feel softer resembling the feel of the natural breast tissue due to its gel-like cohesiveness. This characteristic also makes the implants less detectable even by touch or feel.
Silicone implants are ideal for thin woman with small breasts
Silicone implants experience minimal rippling which is barely visible and may occur mostly when patients lie down on their breasts
Silicone’s cohesive gel allows more a greater variety of implants – i.e, shaped implants are only silicone-based and provide a natural look which is helpful in treating certain conditions related to the chest wall or breast development.
Silicone implants have a 1%/year chance of rupturing similar to saline implants (10% chance after 10 years), however, the rupture is silent which means that you will require an MRI test to diagnose the gel leakage/rupture unlike saline implants, which cause the breasts to deflate making you aware of the problem right away. For many women this is a minor inconvenience for the superior look and feel that silicone implants offer.
Unless they are small, silicone implants can more safely be introduced behind the breasts through the inframammary or peri-areolar approach compared to the transaxillary appraoch (scarless technique)
Silicone implants are more costly
Silicone implants appear in pre-filled form which means implant insertion requires a longer incision on the skin and thus the scar will be longer.
The volume of silicone implants cannot be manipulated.
There is often a concern over safety and monitoring, but silicone implants have a similar complication rate compared to saline implants, and several clinical trials have shown the safety and longevity of silicone implants that allowed them to be approved by the FDA since 2006. The concern over silicone implant safety originated in 1990s when it was speculated (only speculated) that silicone was associated with connective tissue diseases such as cancer, systemic lupus erythematosis, rheumatoid arthritis, scleroderma. This soon led to a moratorium of silicone implants in North America (Europe and Asia never stopped using silicone implants). After over 100 clinical trials showed that silicone implants are not associated with connective tissue diseases, it was not until 1999 that an independent committee of 13 research scientists affiliated with National Academy of Science concluded that silicone breast implants do not cause any major diseases such as depression, lupus, or rheumatoid arthritis, etc. However, silicone was said to be responsible for localized problems such as hardening or scarring of breast tissue. After structural re-engineering of silicone implants, FDA approved them in 2006.
Please note that today's 5th generation silicone cohesive gel implants have been proven to be very durable and safe. In fact, they have lower rates of capsular contracture and silicone gel diffusion. Silicone gel diffusion which can lead to an inflammatory response was a major concern with previous silicone implants along with capsular contracture. This was the case in the 1970s, and this problem cannot be applied in the contemporary context because the more cohesive silicone gel and the higher number of shells prevent silicone’s movement, diffusion, leakage, and exposure to the surrounding breast tissue. In fact, even in the case of an implant rupture,the silicone gel remains restricted inside the shell because of its thickness – this is referred to as “gummy bear silicone”. The new silicone implants have thicker shells, wider variety of surface textures, and implant shapes, giving patients more options to meet their desired looks.
Final Verdict: Silicone implants are very safe and durable.
If your major concern is safety, and you also prefer a natural look, then the new Ideal Implants may the right choice for you. Ideal implants have been created to provide the natural look and feel but with saline as a filler rather than silicone. The unique structure of the Ideal Implants allows for a similar look and feel as silicone with the safety of saline. Ask a board-certified plastic surgeon about IDEAL implants.
Best of Luck!