The concept behind fat transfer for breast augmentation is simple: Move fat cells from one part of your body where they’re plentiful (tummy, buttocks and thighs) to your breasts to enhance their shape and size.

Fat grafting — also known as autologous fat transfer or lipoinjection — was used to enhance or reconstruct breasts as early as 1895, but it wasn’t until the development of liposuction almost a century later that fat cells could be harvested efficiently. While fat transfer via liposuction is widely used today to rejuvenate the face and hands, its application for breast enhancement has lagged behind.

Clinical research into fat transfer breast augmentation continues, and progress is being made to better understand the benefits and risks of the procedure.

Fat Grafting Breast Enhancement Candidates

Currently, fat transfer for breast augmentationis considered an option for women who want to improve the appearance of their breasts after reconstruction or lumpectomy to treat breast cancer, correct a congenital breast deformity like tuberous or “Snoopy” breasts, or repair implant-related issues like rippling and wrinkling. The procedure can also be used to soften the overall look of existing breast implants by “blurring” the line between implant and breast tissue. Potential candidates must also have adequate fat harvesting sites on their body. The American Society for Aesthetic Plastic Surgery (ASAPS) and the American Society of Plastic Surgeons (ASPS) caution women to seek fat grafting for the purposes listed above only.

Both ASAPS and ASPS strongly support ongoing research efforts to establish the safety and efficacy of the procedure for primary breast augmentation. More positive data from those efforts could well make fat transfer to the breast an option for more women in the future. Until then, traditional breast augmentation with implants and auto augmentation with breast lift are options to consider.

Fat Transfer to the Breast: The Procedure

Unlike traditional breast augmentation surgery, fat transfer for breast augmentation actually involves two distinct procedures: harvesting and injecting. The fat cells are acquired through one of several types of liposuction, including laser liposuction, ultrasound-assisted liposuction and water-assisted liposuction.

Once harvested through a syringe, the cells are processed for transplantation. This involves removing anesthetics, lipids, and medical fluids from the fat. The goal is to obtain healthy fat cells devoid of other tissue, which increases the likelihood of successful cell transfer and reduces the chances of injecting unwanted substances with the fat. The healthier and more pure the injected material, the greater the yield of viable fat cells. The PureGraft System by Cytori Therapeutics, approved by the Food and Drug Administration in 2010 for use in the United States, can prepare the fat cells for re-injection in as little as 15 minutes.

After processing, the fat cells are carefully injected, drop by drop in dozens of small injections, into the space between the skin and the breast capsule surrounding the breast and/or behind the breast between the breast and chest wall. This meticulous technique enables the plastic surgeon to sculpt the breasts as desired. The medical consensus is that if the fat is injected into these areas, it will be easier to monitor long term and avoid many of the problems that may arise from significant fat being injected into the breast tissue itself. However, because these injection sites are limited in size, fat grafting to the breast can produce only modest augmentation.

Some surgeons help the process along by instructing their patients to wear tissue expanders prior to surgery. One such expander is the Brava System, which looks a bit like a sports bra and creates a vacuum that applies gentle, three-dimensional pull on the breasts that’s similar to the action of a breast pump. This tension causes the cells to replicate and gradually create new tissue over the entire breast area. If you go this route for breast augmentation, your surgeon will discuss tissue expanders along with other important preoperative information during your initial consultation and subsequent preoperative visits.

Fat Grafting: Issues of Concern

A concern among plastic surgeons is how much fat is needed to get the job done. The consensus here is that fat cells must be over-injected to compensate for any necrosis (cell death) that may occur, which results in loss of fatty tissue. Transplanted fat cells must establish a blood supply in their new location or they will die, taking any augmentation effects they may have had with them. Keep in mind that the living fat cells that remain will fluctuate with weight loss and gain, which means the area where they were injected will change size, too. Women with fat grafts to their breasts may end up with more (or less) than they bargained for if they don’t maintain their weight.

There was some initial concern that fat transfer could obscure mammograms or be mistaken for early breast cancer, but this appears to be unfounded. All women, whether they have large breasts, small breasts or breasts with implants, require different mammography techniques to effectively evaluate their breast tissue. That’s why it’s important to make sure that the technician performing your mammogram is experienced in these techniques. All breast augmentation surgeries pose potential problems for cancer detection. If you have implants, it’s important to let the technician know so that he or she can use the proper technique for imaging augmented breasts. And just as you should tell your mammography technician about any biopsies you’ve had done, you should also tell them if you have had fat grafting to your breasts.

A Word from the Reviewer

Pros and Cons of Fat Transfer to the Breast

The benefits of fat transfer to the breast include no risk of rejection or allergic reaction, since the fat cells come from your own body. The procedure also allows the surgeon more latitude when it comes to shaping the breasts than saline or silicone implants do. There are no incisions; however, there are multiple small openings from the liposuction and injection procedures.

Fat Grafting Breast Enhancement Cost

The bottom line on the efficacy of fat transfer for breast augmentation is that the success of the procedure depends greatly on the skill and technique of the plastic surgeon performing it. If you’re interested in this procedure, please click here to consult with board-certified plastic surgeons who have extensive experience with this technique.