Are Breast Implants Safer Than Fat Transfer for Breasts?

Are Breast implants really safe? I'm 44 and always wanted larger breasts, especially after breast feeding two children (I lost what volume I had). I'm torn about having implants however.
So many women say they have become ill from them and my grandmother had an autoimmune disease thus I may have a genetic predisposition for such, thus I worry whether I should have the implants or try the Fat transfer augmentation method.

Doctor Answers 18

Approach to breast surgery that achieves your ideal breast shape and size in optimal safety and comfort

A fat transfer is a wonderful option to create volume in other areas of the body such as the gluteal area, cheeks, and lips.However, re-using fat in certain areas of the body, particularly in the breasts, is controversial, as it can result in the formation of calcifications and may interfere with mammography in the future.

Breast augmentation is performed most safely and reliably with the use of implants.As one of the most commonly performed and extensively researched cosmetic procedures, numerous studies based on a wide body of data has led the FDA to declare that breast implants are generally safe when implemented properly.Furthermore, while your concerns regarding autoimmune disorders are legitimate, there is no evidence to suggest that implants can cause this disorder.Far less research exists on the safety and reliability of breast enhancement via the use of a fat transfer.

As with any surgical procedure, a full medical history and comprehensive exam with a board-certified doctor is needed to provide you with the information necessary to make and educated decision on how to achieve your ideal breast shape and size in optimal safety and comfort.Your concerns regarding both the risks and benefits of breast augmentation is best addressed by setting up a consultation with a board-certified plastic surgeon in your area with extensive experience and expertise with breast enhancement procedures.

Houston Plastic Surgeon
5.0 out of 5 stars 26 reviews

Fat Transfer can fill only small amount for the breasts

Great question. This is one of the hottest topics in Cosmetic/Plastic Surgery. In fact there is a course being given in Miami in late Jan or early Feb. My opinion is it comes down to size. The Fat transfer can ONLY fill a small amount, less than 200 cc's. Plus the fat injections MUST be deep into the pectoral muscle and its fascia. Vs an saline or silicone implant fills up more of the volume. In fact my average size implant is between 350 cc's to 400 cc's. This gives a real increase in size. I hope other expert posters add to this discussion. So we all can learn. Regards.


Please find an experienced Board Certified Plastic Surgeon and member of the Aesthetic Society using the Smart Beauty Guide. These Plastic Surgeons can guide you on all aspects of facial surgery, breast augmentation and body procedures including tummy tucks or mommy makeovers!

In breast augmentation I have chosen to spend time reviewing photographs with patients to fully understand their expectation of size and shape. Many times this simply raises more questions. I will make measurements and use the implant guides to allow the patient to understand exactly the sizes that are reasonable for their body type and measurements.

Fat grafting is a valuable tool in breast surgery. This technique has gained more popularity over the past 7 years. There are many techniques used to harvest the fat, process the fat and then re-inject the fat. Conventional suction lipectomy is performed with a small diameter cannula, processed by separating the liquid and fibrous tissue from the fat, and then placed into syringes for re-injection or through a closed system.

Silicone Implants are safe and predictable

First of all both Fat transfer which is limited in the amount that your breast can be enlarged at one time and implants are both safe. See the below links for information on both procedures. Here is some more information about the safety of breast silicone implants: Despite three decades of safety testing and monitoring of silicone breast implants, there is still a public perception that silicone breast implants are more toxic or dangerous than saline implants. The truth is that there has no known toxicity from silicone gel breast implants. In fact, silicone is one of the most common materials used in medical devices and implants. There is no known toxicity from silicone gel breast implants. It has been studied by the FDA for more than three decades to establish its safety. Silicone is the most common material used in medical devices/implants. Examples include shunts that go from the brain to the abdomen (for hydrocephalus) which are left in for a lifetime, artificial finger joints, syringes, IVs, catheters (including ones that go next to the heart), surrounding pacemakers, and even oral anti-gas tablets.

The one possible exception may by the PIP implant made in France (generally not available in the USA). Most of the concerns about the PIP implant were about the use of non-medical silicone and manufacturing problems, and do not relate to implants used in the United States by board-certified plastic surgeons. This is not to say that breast implants, like any implant, can have problems; they may have to be removed and are not meant to last a life time. Common reasons for replacement include: capsular contracture, rupture, infection, change in breast size, and pain—but not for toxicity.
To answer the perceived toxicity of Silicone by the general public—this is quite a different matter.
Breast implants have been around since the 1960s. About 15 years ago Connie Chung ran an exposé, Face to Face with Connie Chung, claiming silicone implants were responsible for different health problems. This led to lawsuits, a huge windfall for lawyers, and the subsequent ban on silicone implants for first-time breast augmentation patients went into effect. They were always available for breast reconstruction (e.g. after mastectomy) and replacement of existing silicone breasts. Also, please note that saline implants are still covered by a silicone envelope.
Soon after, a ban on silicone implant use became worldwide. This lasted for years until more than 100 clinical studies showed that breast implants aren’t related to cancer, lupus, scleroderma, other connective tissue diseases, or the host of other problems they were accused of causing.
June 1999, The Institute of Medicine released a 400-page report prepared by an independent committee of 13 scientists. They concluded that although silicone breast implants may be responsible for localized problems such as hardening or scarring of breast tissue, implants do not cause any major diseases such as depression, chronic fatigue syndrome, lupus or rheumatoid arthritis, etc.
The Institute of Medicine is part of the National Academy of Sciences, the nation’s most prestigious scientific organization.
Eventually, a federal judge dismissed/rejected the lawsuits, declaring them junk science and ended for the most part the barrage of lawsuits. This led to the present reintroduction of silicone implants years ago and their approval by the FDA. Interestingly enough, most of the rest of the world reintroduced them many years prior to the United States.

Larry S. Nichter, MD, MS, FACS
Orange County Plastic Surgeon
5.0 out of 5 stars 109 reviews

Breast Implant Safety

The studies have been done and all the accusations of breast implants causing autoimmune problems never proved true.

At this point this is the only safe way to enlarge the breasts. Fat grafting is being done but it is a bit risky as we dont know what it will do when it comes to breast cancer screening. Also, fat grafting has its limits as far as size goes and its limits are at the small scale.

Hope that helps.

Farbod Esmailian, MD
Orange County Plastic Surgeon
5.0 out of 5 stars 65 reviews

Safety of fat transfer to breasts

I think that the question that needs answered is whether or not fat transfer is safe. We know the safety of breast implants. What we do not know is how fat transfers will affect future mammography of the breasts. Calcifications from non viable fat may produce a need for breast biopsies or increase the difficulty in reading mammograms.

Dean Fardo, MD
Atlanta Plastic Surgeon
5.0 out of 5 stars 11 reviews

Breast Implants or Fat Injection

Multiple studies have conclusively proven the safety of breast implants. This includes proving that they do not cause autoimmune disease. Fat injection, on the other hand, does not have enough data yet to prove whether it is safe. Even if it is eventually proven safe, the technique does not add significant size to the breasts.

Robert T. Buchanan, MD
Highlands Plastic Surgeon
5.0 out of 5 stars 5 reviews

Breast implants are very safe

Breast implants are very safe. They do not cause autoimmune disorders. As to the question of fat injections, this is still controversial and I would not recommend it now.

Steven Wallach, MD
New York Plastic Surgeon
4.0 out of 5 stars 23 reviews

Safety isn't really the issue for breast implants vs. fat transfer

It is truly remarkable that people are still talking about autoimmune disease and implants, since any questions about a possible association were dispelled by several large studies in the 1990's. Even the National Instututes of Health have confirmed, in a detailed response to a request from Congress, that medical grade silicone is non-toxic and doesn't cause disease conditions.

Fat grafting, though it has had a controversial history (it was formally banned by the American Society of Plastic Surgeons for 20 years) seems to be on the verge of a comeback. Here is a list of pros and cons:

  • Implants allow for precise determination of size and dimensions in one operation
  • Fat grafting may take several sessions and there is an upper limit to how much can be done
  • Fat grafting might require a period of skin expansion with a BRAVA device, which many find cumbersome and inconvenient
  • Since fat grafting is not commonly done, few plastic surgeons have much experience with it in breasts

Bottom line is that the decision shouldn't be based on a presumption that silicone implants may cause autoimmune disease.

Richard Baxter, MD
Seattle Plastic Surgeon
5.0 out of 5 stars 42 reviews

Breast implants much better than fat transfer.


Breast implants are completely safe. It is not that fat transfer is unsafe.  It's just that it is very hard to get enough breast augmentation with fat, and how much lasts is unpredictable.

George J. Beraka, MD (retired)
Manhattan Plastic Surgeon
5.0 out of 5 stars 9 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.