As a plastic surgeon, I am invested in the transformative power of breast augmentation through
various techniques. However, I respect that implants are not for everyone and once I have
understood a patient’s objectives, I consider it my role to suggest possible alternatives (often
auto-augmentation). However, another approach that has garnered significant attention in recent
years is fat grafting for breast augmentation. While this method can offer unique benefits, it is
important to shed light on both its advantages and potential complications.
Understanding Fat Grafting
Fat grafting, or lipofilling, entails harvesting fat from areas like the abdomen or thighs and
injecting it into the breasts. It’s an intricate procedure that requires precision and expertise.
Advantages of Fat Grafting for Augmentation
1. Natural Aesthetics: Utilizing a patient’s own fat may result in a more natural appearance
and feel.
2. Avoidance of Implant-related issues; including concerns around implant longevity.
3. Body Contouring: Simultaneously achieving breast augmentation and contouring donor
areas provides a dual benefit.
4. Reduced Scarring: The procedure’s incisions are minimal, translating to less noticeable
scars.
5. Potential for volume restoration post implant removal: Encompasses all the above!
My perspective on Limitations and Complications
While fat grafting holds promise, it’s not without potential limitations:
1. Fat Resorption: One of the primary concerns is the unpredictability of fat survival. Not
all transferred fat cells persist, leading to potential asymmetry or volume discrepancies
over time.
2. Breast shape limitations: Unlike an implant, which confers structure to the breast, fat
relies solely on the integral shape provided by the existing breast tissue and skin
envelope. A lift performed in conjunction with fat grafting can help address this.
3. Calcification: There have been reports suggesting that fat necrosis (death of fat cells) can
sometimes lead to calcification, which might interfere with mammogram interpretations.
This has recently been rendered somewhat historical with increasing radiological
experience. There is extensive literature refuting any link to precitipating new cancer*.
4. Infection Risk: As with any surgical procedure, there’s a risk of infection, albeit
minimal. Ensuring sterile techniques and post-operative care is paramount.
5. Cyst Formation: Occasionally, patients might develop cysts or lumps due to the injected
fat, necessitating further evaluation or intervention.
6. Misplacement Issues: The injected fat must be distributed evenly to prevent
irregularities or palpable nodules, which can compromise aesthetic outcomes.
Concluding Thoughts from Dr Bovill
While fat grafting offers a promising avenue for breast augmentation, it is vital for patients to be
aware of potential complications and choose their procedures wisely. As a specialist breast
cosmetic and reconstructive plastic surgeon, I do perform fat grafting routinely and am deeply
familiar with its benefits and limitations. It is not the panacea to all implant concerns, but, if you
are seeking a subtle and soft boost in volume and have good soft tissue structure, or are open to a
lift to restore that, it may yet be the augmentation unicorn!
You can view photos of fat grafting breast augmentation done at our Vancouver clinic in our before and after photo gallery.
*Myckatyn TM, et al. Cancer Risk after Fat Transfer: A Multicenter Case-Cohort Study. Plast
Reconstr Surg. 2017 Jan;139(1):11-18.