Breast Augmentation Without ANY Silicone?

All breast implants, saline or silicone, have a silicone rubber shell. I have never seen any patients react to the silicone rubber, which is an inert material. If you are concerned you can have a skin test performed to check for possible sensitivity. Work is being done on fat transfer to the breast, but there are still many concerns about breast cancer followup with calcification or fat necrosis after injection into the breast. It is not a approved procedure yet.

The weight of evidence over the last 20 years since silicone gel-filled implants were first removed from the market (for cosmetic breast surgery only....still have always been available for reconstruction) has not proven conclusively that systemic disease processes such as collagen vascular diseases are linked directly to implants.

The use of silicone gel filled implants world wide has persisted and since the ban was lifted in the US in 2006 the numbers of women with these implants have risen without any significant incidence of systemic problems although of course locally in the breast, any implant can lead to scarring and infection as with any surgical procedure. 

Some women opt for saline filled implants as you mentioned.

Regarding fat transfer to the breast, that is a relatively new but growing area of interest. Nationwide, there are a handful of plastic surgeon advocates and ardent enthusiasts although the vast majority of augmentation procedures are still performed with implants.  It will likely be some time before the option of fat transfer becomes much more common and widespread.