Fat transfer has taken the plastic surgery field by storm. I use fat transfer to augment different areas of the body, including the hips in the hourglass hip procedure and the buttocks in the hourglass buttock augmentation procedure. However, some patients are requesting fat transfer to the breasts. This is another procedure that can be performed to enhance your breasts. Fat is harvested from the abdomen, flanks, sides, back, or any area where you have excess fat, and then the fat is injected into the breasts. You can use fat transfer for primary breast augmentation, meaning you have not had any other breast procedures and you just want to use fat instead of an implant for an augmentation. I prefer using an implant rather than fat for this type of situation. One of the controversial issues with fat transfer is that some of the fat that is transferred dies; this is the norm in almost every patient, but when the fat dies in the breast, it creates calcifications that can be misinterpreted as cancer during a routine mammogram. There are many studies trying to figure out the difference between calcifications secondary to cancer and those secondary to the breast enhancement procedure with fat. I have found breast fat transfer to be very useful in revision breast surgery. A revision breast surgery is done because the breast volume has been altered significantly by the pressure of the implant on the breast itself. Many times, when you insert an implant, there are certain areas that are not corrected completely with fat. Also, in patients who have had secondary breast surgery with a lift and augmentation, sometimes the implant has bottomed out and they have lost upper pole fullness. Instead of performing a more extensive breast lift, a skin-only breast lift can be performed and fat transferred to the top of the breast to provide fullness. Fat transfer is certainly something that I consider in my cosmetic practice. I do not recommend it for just breast augmentation, but as an add-on procedure to enhance your breasts in secondary breast surgeries.