Fat Grafting with Stem Cells vs. Breast Implants

After much research into both silicone/saline implants,I just wasn't comfortable with the complication rate of either,namely within five years of implant more than 40% of patients require a second. Also,reading many personal stories of women who had explant surgery due to various health problems including ruptured or leaking implants,especially pics of saline implants black with mold from faulty valves was disturbing. Fat grafting with stem cells sounds great,but very costly and not many ps do?

Doctor Answers 22

Breast augmentation via fat grafting is possible, but has its own concerns.

The published data on reoperation rates for implants based on the FDA core studies is 15% at 3 years for primary augmentation patients. I do not know where you got the 40% reoperation rate, but this in incorrect. As for fat grafting, it is definitely possible, however it has its own drawbacks. Here are some basics:

  1. You need to have modest expectations as to increase in breast size. Realistically, a cup size is about all one can expect.
  2. You need to have enough fat to harvest in order to inject. Extremely thin or athletic patients simply do not have the often 500-1500cc of fat necessary.
  3. The fat has to live after transplantation. If the fat does not become revascularized, it will die and be resorbed by the body. This can lead to issues with calcifications, fat necrosis, fat cysts, contour irregularities, and volume loss (often asymmetrically between two breasts).
  4. It requires a significantly longer operation - usually several hours more in order to harvest the fat, process the fat, and inject the fat.
  5. The "stem cells" are more marketing than reality. The increase in breast size is due to the addition of mature fat cells more than stem cell regeneration. The stem cells may have a role in increasing vascularity to the tissue after transplantation and research is beginning to show this role.
  6. The cost is significantly more, mostly due to the increase in the amount of work required.

We all would love a totally "natural" breast augmentation that improves other areas of the body and leaves us without worry of complications. Unfortunately, that does not exist. There are risks of any procedure. If you are willing to accept the risks of fat grafting for breast augmentation, then this may be the procedure for you. Be sure to see a plastic surgeon with extensive experience in this procedure. In the Washington, DC area, I would recommend Dr. Scott Spear at Georgetown University Hospital as I know personally that he has performed fat grafting for breast augmentation many times.

Boca Raton Plastic Surgeon
5.0 out of 5 stars 18 reviews

Stem cell instead of breast implants

Fat grafting to the breasts can be done but the results are really diappointing. The fat usually dissolves with time and the amount of enlargement is about one cup size. In my experience, the chances of re-operation with silicone implants is very small. I have been doing these for over 15years and I would be surprised if I have re-operated on 5% of my patients. They have proven to be safe and the manufacturers have improved the silicone implants so the chances of hardening or capsular contracture is about the same as with saline implants or about 10%. The satisfaction rate amongst my patients is very great. I am offering a all inclusive fee that is extremely reasonable as well as interest free financing for some patients.

Edward J. Domanskis, MD
Newport Beach Plastic Surgeon
4.4 out of 5 stars 27 reviews

Stem cell augmentation

You are right on both scores.The procedure is very,very expensive and few doctors do it.One concern is what happens to the fat that doesn't take? Can this cause suspicious calcifications? More needs to be done and more studies conducted.

Robert Brueck, MD
Fort Myers Plastic Surgeon
5.0 out of 5 stars 53 reviews

Fat Grafting - Stem Cells. Good alternative

Fat grafting to the breast is a very reasonable alternative for the right patient.  There is a volume limitation with fat injections to the breast that may make implants more appropriate. However, fat grafting can provide volume and it can be used to enhance specific areas of the breast.  We have been using fat grafting since 1995 with predictable results and terrific patient satisfaction.  It has become accepted for the breast in the last several years. Common uses besides the breast include, buttocks, face and hands for a variety of purposes. The key to the procedure is the technique the surgeon uses.

Marc Schneider, MD
Fort Myers Plastic Surgeon
4.7 out of 5 stars 14 reviews

Fat Grafting for Breast Augmentation

A forty percent (40%) complication rate for primary breast augmentation? Can you quote the source of this? When the FDA put a freeze on silicone breast augmentation surgery in the early 1990s, one of the issues they highlighted was a "high" reoperation rate that plastic surgeons and implant manufacturers AT THAT TIME could not completely explain...however, since that time, a majority of the reoperative cases in studies since that time, have pointed to patient driven indications, namely, "bigger size, want a lift later, switch from saline to silicone,etc.". But a 40% complication rate as a blanket statement is a bit inaccurate.

NEXT, have you seen any GOOD before and after results from fat/stem cell transfer to the breast? I have not, at least NOTHING that looks as GREAT as traditional prosthetic breast augmentation. And, have you heard how many "treatments" it takes....at least 3 visits to the operating room! That's a HUGE expense....

NEXT, does it last? Well, plastic surgeons are performing controlled clinical trials to assess this and the verdict is still out. I was recently interviewed for a local TV station regarding this issue. The "other" MD they interviewed, who is NOT a Board Certified Plastic Surgeon BUT offers fat transfer to the breast for augmentation(?), tells her patients that she sees "greater than 90%" retention of the grafted fat! Unreal and unrealistic results as far as I am concerned. In the best of hands, 30 to maybe 50% of the transferred fat is retained in my hands....the results are ok to good. We are still looking into our results and as INNOVATIVE surgeons and scientist are researching the answers to long-term large volume fat transfer....BUT we are not there yet!

Sorry for the long-winded answer!

Hope this helps!

Dr. C


John Philip Connors III, MD, FACS
Atlanta Plastic Surgeon
4.8 out of 5 stars 45 reviews

Grafting with Stem Cells instead of breast implants?

There is no FDA authorized stem cell procedure in the United States. There are many people claiming to do stem cell facelifts, stem cell breast augmentation, stem cell anything. This is a bit of smoke and mirrors. Anytime you do fat grafting you are actually transferring stem cells along with it so all Brazilian Butt Lifts can also be called Stem Cell Brazilian Butt Lifts. It is still not clear whether stem cell augmentation to fat grafting actually does anything. The whole idea is still quite experimental. You have done a lot of research on the Internet and possibly too much since you have come on some very gruesome sights with reference to breast augmentation. The vast majority of women are happy with their implants and love them. The 40% figure is vastly overrated and may have been published in some reconstructive series which has higher complication rates. In my practice reoperation is approximately 5%. You should go see a board-certified plastic surgeon experienced in breast surgery and discuss your concerns. There are several people around the country doing breast augmentation with fat. I have done some of this myself and it works. However it is a much longer and costlier procedure.

Andrew Kaczynski, MD
Sacramento Plastic Surgeon
4.9 out of 5 stars 105 reviews

Stem cell grafting for breast augmentation

Stem cells are one thing and fat grafting is another but sometimes the names are interchanged.  This is still experimental and if it is fat grafting you are talking about, may not give the volume that you desire.

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

Stem Cell Grafting to Your Breasts is Still Investigational

Stem Cell grafting for breast augmentation is still in its early stages.  And while breast implants are far from perfect, the pictures you see of "moldy" valves and so forther are generally the worst case scenario and extraordinarly rare.  In addition, as pointed out in previous posts it is better suited for someone looking for a very subtle enhancement and not more than about a cup size increase.

In my clinical experience, most patients will require a revision in their lifetime but few require it within the first several years following their augmentation.  To increase your chances for a succesful surgery, I suggest that you do the following:

  • choose a physician who is Board Certified in Plastic Surgery and who specializes in breast enhancement.  In this day and age, seemingly ever physician is entering the ring and so you may not know who is the best and who you should avoid.  Plastic Surgery training is an excellent first step and is obviously far more comprehensive than the weekend course or the physician who simply "shadowed" a plastic surgeon for a few weeks
  • ask to see before and after's
  • ask to speak with at least 3 actual clients who have undergone this procedure

And, finally, go with your gut.  Above all, do not use price as a means to choose your surgeon.  It is far more difficult to fix a bad result than it is to get it right the first time.

Stem cell breast augmentation

Stem cell breast augmentation is another term for fat grafting into the breast to increase cup size. The procedure is considered 'investigational' at best and is not widely practiced. We would not consider fat grafting an acceptable alternative to breast implants which have been very well studied and are infinitely safer.

Best of luck,


Peter E. Johnson, MD
Chicago Plastic Surgeon
4.1 out of 5 stars 39 reviews

How many Drs use Grafting with Stem Cells instead of breast implants?

Very few are experienced using Stem Cell + PRP activated Fat grafts. It is not a replacement for implants of size. Grafting can only increase a half to full cup at best, it is better as a filling of the breast as if you are having a very strong menstrual cycle. Longevity of the grafts a the real issue. I'm preforming this treatment more and more as my experience increases so do my results. I have now added this to my breast enhancement protocol. And yes the cost is double the implants, in the $10,000 range. From MIAMI Dr. Darryl J. Blinski

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