In the past few years, fat grafting to the breasts has emerged as a new modality that can give women another alternative to implant augmentation surgery. However, this technique may not suit every patient and what works for one, may not work for another.
 
Breast augmentation using fat transfer, essentially uses liposuction to take fat from other parts of your body and inject it into your breasts. It is a good option for women who are looking for a relatively small increase in breast size and would prefer natural results.
Furthermore, with this technique, you will also have the bonus aesthetic advantage of adding “free” liposuction to your breast surgery i.e. breast and body contouring surgeries, combined !
As opposed to fat grafting, breast implants tend to give you better fullness in the upper pole of your breasts that is predictable and more controlled by the surgeon. You can also go much bigger with your cup size.
Therefore, in those patients who desire larger cup size, fat grafting may not be an option and implant augmentation surgery will serve them best. It is also the most reasonable option for those  patients who do not have sufficient fat stores as potential donor sites.
With fat grafting, fat is collected via liposuction, washed with antibiotics, strained and injected into the breast tissue. Using this technique, you can only go one to two cup sizes bigger based on the current recommendations of the American Society of Plastic Surgeons. Therefore, it may not be the option of choice in lean patients.
In summary: Implant augmentation surgery is best suited for patients with slim body with insufficient fat stores or those patients who desire a large cup size. Especially that subset of patients whose upper pole fullness is very important to their ultimate aesthetic look.
On the other hand, fat grafting is best suited for patients who do not want to have breast implants or those with enough fat stores that can support a modest cup size increase. I also suggest it to those patients who incurred recurrent problems with their implants such as recurrent capsular contractures. In these patients, I recommend removing the implants in one stage. Wait 3 months at least before we inject fat as a secondary stage.
Cost is also another matter to consider. Fat grafting tends to be more technical and takes more time: to obtain the fat by liposuction, collect it, strain it, fill it up in syringes and inject it in a meticulous way. Since it takes longer time to perform, you may be expected to pay a higher cost for the procedure.
 
Breast augmentation whether by implant or fat grafting can be combined with breast lift in a single stage in the right patient.
Board Certified Plastic Surgeon, Dr. Maan Kattash is a specialist in Liposuction and Body Contouring Surgery. Click here to see more of the procedures performed by Dr. Kattash at: https://www.drkattash.com/body-plastic-surgery-los-angeles/liposuction/  in our Beverly Hills, Rancho Cucamonga and, Irvine locations or call 310-550-6174 to schedule a complimentary consultation.
Useful References: