Fat grafting for breast augmentation - what women should know

March 5, 2013
American Society for Aesthetic Plastic Surgery (ASAPS)

The idea of taking your own fat and repositioning it to augment your breasts has captured the attention of both consumers and the media. Although there has been some research on the safety and efficacy of this procedure, more research is needed before concluding that the procedure's benefits outweigh the risks.

The American Society for Aesthetic Plastic Surgery (ASAPS) urges consumers to proceed cautiously since temporary benefits may be offset by long-term problems with self-examination and mammography ultrasound and MRI evaluation of the breast in screening to rule out breast cancer. Specifically, ASAPS believes you should consider the following before consultation with a board-certified plastic surgeon about fat grafts for breast enhancement.

What is fat grafting?

Fat grafting, also known as fat transfer or lipoinjection, is a process in which fat cells are harvested from one part of the body and injected into another. It is a procedure with few surgical complications and is most commonly used to provide the face and hands with a more youthful appearance which may be permanent.

How long has fat grafting been used for breast augmentation?

Augmenting the breast with the body's own fat first became popular in the 1980s; however, ASAPS initially cautioned its members against the technique because of side effects such as oil cysts, calcification, and tissue scarring. The calcification in particular made it difficult to distinguish mammographically between calcifications associated with breast cancer and calcifications associated with fat transfer.

What has changed since then?

More recently, radiology literature suggests that new generations of mammography equipment are more sophisticated than their predecessors and better able to distinguish cancer cells from benign ones. This is particularly true of digital mammography, especially when examining dense breast tissue.

The methods for harvest and injection have also been refined. Today, fat cells are carefully removed by liposuction using syringes and transferred to the breast via dozens of small injections. This technique may result in increased survival of the fat cells, although there remains a debate over how much of the transferred fat remains long term.

Is fat grafting a better or safer alternative to saline or silicone implants?

Little clinical evidence, pro or con, exists to suggest that fat grafting is safer or better than saline or silicone implants.

What are the risks?

Fat cells removed from one body site and injected into another frequently do not survive. Fat injected into the breast may be absorbed by the body, may become liquid and form a cyst, calcify, or produce scarring within the tissues. Seven to 14 ounces of fat injected into the breast, the amount required for an average enlargement, can still result in calcifications, oil cysts and scarring that can mimic or obscure breast cancer.

What are some of the other issues involved with fat grafting for augmentation?

The process requires multiple sessions and typically increases breast size at the most by only one cup. The recovery time may be longer than with traditional implants, as both the breast and donor site must heal. You will need to have an adequate supply of excess fat for the procedure. And it can take up to six months or more for your result to take shape after the procedure as opposed to implants where your final result appears in six to eight weeks.

Is there an acceptable application for this procedure currently in use?

Yes. Fat grafting can be very effective in enhancing the appearance after breast reconstruction. The procedure can also soften the appearance of existing implants, particularly in very thin women and hide visible rippling. It is also an accepted application for facial and hand rejuvenation.

What does ASAPS recommend?

The American Society for Aesthetic Plastic Surgery recognizes the growing interest in fat grafting for breast enhancement, and we are continuing to monitor clinical evidence which documents the safety and efficacy of this procedure. Fat grafting to the breast is showing promising results and may become a popular breast augmentation procedure. We recommend that patients meet with their board certified plastic surgeon and discuss the most recent research and options.