Breast augmentation by fat transfer is not the same as breast augmentation with implants and should not be considered an alternative to it.
Breast augmentation with implants produces a variety of shapes, virtually all defined by rounder, fuller and more projecting results that are different from the outcomes that can be achieved with fat transfer.
Fat transfer can be used to increase breast size, correct breast defects, aid in correcting implant problems, and completely or partially reconstruct breasts that have been removed or reduced by surgery or trauma.
In 2009 the American Society of Plastic Surgeons reviewed the issue and found no objective data denying the benefits of fat transfer. Radiology literature (see Dr. Eva Rubin, Chief of Breast Radiology of U of Alabama) confirms the radically different nature of the changes observed in mammograms after fat transfer versus tumors, and in recent article published in the American Society of Plastic Surgeons Journal, the procedure that leads to most "questionable" mammograms in the years following the surgery is breast reduction and lift, causing vastly more biopsies and additional tests than fat transfer.
Any doctor that has removed an old breast implant with hard capsule can honestly say that those findings are vastly more obscuring to breast tissue and interfere with mammogram more than any other surgery. Fat necrosis, which is the culprit of the discussion about fat transfer causing calcium deposits and cysts and other mammographic problems, may be present in any surgery and it is the hallmark of breast reduction and lift procedures.
There are multiple centers in the US where fat transfer to the breast is performed safely, effectively, and in controlled settings. For women who prefer to avoid breast implants and wish for a natural increase in breast size fat transfer is a viable and effective alternative to breast implant when performed in centers with appropriate expertise and adequate follow up.