Are there any plastic surgeons who do spiral flap Breast Augmentation?

The farther you go from the breast to obtain tissue, the longer the length of the flap, or piece of tissue, that has to remain connected at its base like an island, or more accurately, a peninsula, to get its blood supply.  If you create a flap that is too long, you detach too much tissue from its blood supply, and it dies.  Add to this the fact that fat tissue is notoriously poorly vascularized and has a marginal blood supply anyhow, so disconnecting large flaps of fatty tissue from its blood supply has a high risk of death of that tissue.  When fatty tissue dies it loses volume and shrinks, it turns to an oily liquid and typically includes fibrous scar and calcium deposits, and it can get infected or inflamed.  All of these things can, and do, happen to fatty tissue within the breast as well as fatty tissue from outside of the breast transferred in to augment the size of the breast.  I would not advise such a procedure.Fat transfer using specially prepared fat grafts taken from the fat removed with a liposuction procedure that are then injected into the breast (or other areas like the buttocks, too), is a much more reliable way to use your own fat for increasing breast size.  If done properly, this has a higher rate of survival of the fat cells and much less risk.  It is also MUCH less invasive, and the healing time will be MUCH faster.  One important thing to consider in all of this is whether the breasts need to be lifted or repositioned in addition to augmented, and if this is the case, it is likely that fat transfer should be delayed until after a lift can be performed and the breasts fully healed.  

Using the tissue for auto (or self) augmentation from the bra line and upper back is sometimes done as part of breast reconstruction. I have also used part of the tissue with  a mastopexy or breast lift to also slightly increase the size of the breast.For breast augmentation alone it would have a lot of negatives. Cost would be much higher than implants. Scarrring would be severe, and potential healing problems. And the fullness would not be as even or as shaped as an implant.I dont think many surgeons would offer this over implants. If you need a lift, and need slightly larger using the lateral tissue can help auto augment and is reasonable.If your primary goal is to tighten up the lateral side due to weight loss and loose skin, and rather than throw the tissue away you would like to use it to augment a mastopexy it would be a reasonable procedure. If your goal is primarily augmentation then a cohesive gel implant is easier, less expensive, and more consistent.I have done auto augmentation or an extended mastopexy frequently but as part of a mastopexy or breast reconstruction.