Should I get silicone breast implants or fat transfer surgery? I would like a natural look and feel. Which is the best option?

I am a healthy, 5'2, 42 year old woman. I would like to increase my breast size from A to B or C. I am aiming for a natural look and feel, so am strongly considering fat transfer. I met one PS so far, but he seemed to think I would be better getting breast implants. I would prefer getting fat transfer. I was told that my body might reabsorb the fat and that the financial investment would be lost. I do not like the thought of having implants in by body that I will eventually need to replace.

Doctor Answers 9

Fat Transfer or Breast Implants?

Thank you for your question.  In my experience, fat grafting is best for those who want a very small increase in their breast size, although we frequently use some fat transfer to enhance results with breast implants and for those who have explant surgery. It is true that your body will absorb some of the fat from a fat transfer, and without a physical exam, it is difficult to assess how much fat you have for the transfer procedure.  You might want to explore the new Ideal implants, which are a structured saline implant.  These implants provide a very natural look and feel, and are completely safe as they are saline (salt water). There is no need to monitor them with an MRI for silent rupture, and patients thus far have been very happy with results.  That said, no implants are guaranteed to be life time devices and it is not uncommon for women to have their implants replaced every 10-20 years.  I hope this is helpful.

Grand Rapids Plastic Surgeon
4.9 out of 5 stars 70 reviews

Fat versus Implants

Fat grafting to the breast has gotten more press over the last few years. It has been a great way to enhance the results of breast reconstruction and has been used in breast augmentation as well. The typical candidate for augmentation with fat does not need much volume and has adequate donor fat to be used. This is usually not the case in most women and therefore the implant is the better choice. Implants can be long lasting and replacement is not a given. A second opinion in your situation could help you make the best choice.

Jeffrey W. Hall, MD
Austin Plastic Surgeon
4.5 out of 5 stars 19 reviews

Breast implants versus fat transfer

Probably the most significant concern here is your expectations. Fat transfer is very limited as far as the amount of volume that can be added. Most woman would require and implant to produce the final effect they are looking for.

Ira H. Rex lll, MD
Fall River Plastic Surgeon
4.6 out of 5 stars 46 reviews

Should I get silicone breast implants or fat transfer surgery?

Fat is, of course, more natural. With a very experienced surgeon doing the fat transfer patients can get 1/2 cup size long term increase and sometimes a little more. It does not sound like you are a good candidate emotionally for implants. 

Ronald V. DeMars, MD
Portland Plastic Surgeon
5.0 out of 5 stars 27 reviews

Should I get silicone breast implants or fat transfer surgery? I would like a natural look and feel. Which is the best option?

Your surgeon seems to have given you a realistic expectation for the results of fat grafting versus implants. 
Fat grafting has limitations as to how much volume can be added at one time, the need for multiple procedures in most patients, and complications with resorption, oil cysts, and calcifications. Typically a cup size increase is all that is feasible with fat grafting. 
While implants do also have complications and need replacement, the vast majority of patients are very happy and have few problems. 
Good luck with your decision.

Don W. Griffin, MD
Nashville Plastic Surgeon
4.8 out of 5 stars 73 reviews

Fat grafting versus implants

I have a large experience with breast fat grafting.  It is critical to understand the limitations of the procedure.  If you really only want a one cup size increase, then it may be possible to achieve it with fat grafting.  If you have enough extra fat for two grafting procedures then the outcome can be even better.  

Fat grafting for primary augmentation is not commonly performed, so you will need to consult with a surgeon with a large experience with the procedure to get the best opinion.

Best wishes, 

Dr. Connall

Timothy Connall, MD
Portland Plastic Surgeon
4.8 out of 5 stars 37 reviews

Fat transfer

Fat transfer can be done to increase your size half cup to one cup. However, some fat may be absorbed over time. Also, if you loose weight, you may loose some of your fat. Breast implants do give a more stable size and shape over time. I would suggest discussing the fat grafting again with your doctor, or getting a second opinion. Should you want a 2 cup size increase, implants are a better choice.

Connie Hiers, MD
San Antonio Plastic Surgeon
4.6 out of 5 stars 13 reviews

How to Achieve a Natural Aesthetic Result

Breast augmentation by fat transfer, known as lipoaugmentation, is one way to achieve natural-looking, fuller breasts. Whether it is better to have breast augmentation done using implants or fat transfer is based on the patient’s desired results. As with any cosmetic procedure, there are pros and cons to both types of procedures. While lipoaugmentation is said to promote a more naturally aesthetic result, there is concern regarding survival of the fat cells after transfer. The amount of volume can be limited in thinner patients which may limit the ability for you to achieve the size you desire. There are so many shapes and sizes of implants available today that patients can achieve a natural shape and feel with implants as well. These include newer 5th generation silicone round implants and anatomic-shaped “gummy bear” implants. We also now offer the Ideal structured saline implant which has the feel and performance of a silicone implant with the ease of monitoring of traditional saline implants. Whether a revision is necessary later on depends on many factors, which is why it is important for patients to keep up with their annual follow-up appointments after their surgery in order to ensure breast health, implant integrity, and their satisfaction. During an examination by your board-certified plastic surgeon, you can be evaluated to determine a customized plan especially for you. Good luck with your research!

Jerome H. Liu, MD
San Jose Plastic Surgeon
5.0 out of 5 stars 14 reviews

Should I get silicone breast implants or fat transfer surgery? I would like a natural look and feel. Which is the best option?

While fat transfer is a great option if you don't want implants, it is less predictable so the results are varied. 

Karol A. Gutowski, MD, FACS
Chicago Plastic Surgeon
4.9 out of 5 stars 68 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.