Fat transfer can increase the volume of the breasts without the use of implants. The procedure is commonly performed nowadays and with high success rates. But how is it different from breast implant surgery and what entails each procedure?In this article, we will discuss the two methods used nowadays to enhance the size of the breasts and also the results they provide and the risks and potential complications associated.Fat transfer to the breastsNowadays it is possible to perform a breast augmentation without using implants. The procedure entails the use of the patient’s own fat cells that are collected from areas with an excess of fat and then reinjected into the breasts. The fat transfer procedure has been performed for quite a few years now, and it has the main benefit that it allows a more complex sculpting of the body through liposuction. In other words, not only will the patient have larger, rounder, better-contoured breasts, but she will also have a slimmer waist.The journey to enhance the breasts with the help of fat transfer starts with the consultation with the plastic surgeon who will confirm the absence of any contraindications for the procedure. To be an eligible candidate for fat transfer, the patient needs to have a surplus of fat tissue in other areas of the body. At least 800-1000 ccs of fat should be harvested with the help of liposuction to make the procedure feasible and visible. The patient will be requested to undergo a mammogram before the procedure to ensure there are no unknown formations on the breasts that could make the procedure contraindicated.When considering fat transfer to the breasts, it is important to know that the procedure has both advantages and disadvantages.Advantages:– Lipofilling makes it possible to increase the breast volume without placing implants thanks to the injected fat and makes the procedure less invasive;– Allows the patient to gain breast volume to remove unsightly fat deposits from the buttocks, hips, thighs, or abdominal area– The procedure will leave behind very small scars on the areas treated with liposuction. Often the scars are no longer than 3-4 mm.– There are no risks of developing the complications associated with using breast implants, such as capsular contracture.Disadvantages:– The increase in maximum breast volume is more limited compared to undergoing breast implant surgery– The intervention can’t correct breast ptosis– The results vary on the patient’s ability to maintain a constant weight after the procedure.Surgical steps of the procedure:The procedure is performed in the clinic or a hospital, under local anesthesia with sedation or general anesthesia. The patient doesn’t need to spend a night at the clinic and the exit can take place the same day, just a few hours after waking up from the effects of the anesthesia.• Liposuction is first performed to obtain the amount of fat needed for the transfer• The fat will then be processed and treated to keep only the living fat cells that can be reinjected into the breast• A small cannula is then used, and micro-incisions are made. The incisions are similar in size to the ones performed for the liposuction, and this is how the fat transfer begins.• Dressing and compressive bandages are placed over the breasts and the patient is moved to the recovery room.The pain in the breasts is less intense than when placing implants. The pain is mostly felt in the areas treated with liposuction, especially if a significant amount of fat was extracted or the area treated is extensive.Results after breast lipofillingBreast lipofilling increases the volume of breasts, usually with half a size or maximum one cup size. Lipofilling does not allow a radical transformation of the shape of the breast and a consequent gain in breast volume.Edema is always present after the procedure, and the result cannot be judged until after three to six months. This technique is suitable for women who are looking for a moderate increase in their breast more than a dramatic transformation. If the expectation is realistic, the patients are generally very satisfied with the results.This technique also makes it possible to correct certain defects after a breast surgery already performed, such as the visible contour of the implant, apparent folds, or an increase in volume secondary to the placement of implants.The long-term consequences of fat transfer are less significant compared to an increase with implants. A simple edema and moderate pain, addressed by a simple analgesic treatment, are to be expected. It is important for the patient to keep a constant weight after the procedure as otherwise the results can be compromised.Breast implant surgeryBreast implant surgery has been performed for over half a century now, and the results can be spectacular if a talented and experienced plastic surgeon is performing the procedure. To be eligible to undergo breast implant surgery, the patient needs to be free from any contraindications such as severe blood, heart or lung conditions. The procedure is recommended for patients who want to see a significant increase in the size of their breasts, for thin patients, and also for patients confronted with minor breast ptosis.Breast augmentation with implants is a procedure more complicated than fat transfer, even if in terms of operating times it can actually last less than the fat transfer. The procedure is often performed with the patient under general anesthesia and lasts about one hour and a half.The procedure entails larger incisions that are dependent upon the operative plan that was chosen and also the size of the implant to be used. Moreover, the procedure is associated with a higher risk of developing an infection compared to the fat transfer, along with a suit of complications associated with breast implants such as capsular contracture, implant rippling, implant rupture or leaking.However, it is important to mention that the results that can be associated with breast implant surgery can’t be achieved with the fat transfer. Moreover, it is also about the durability of the results. The results of fat transfer are subject to weight fluctuations, while the results of breast implant surgery are more stable in time and not affected by weight changes. The implants inserted will keep their volume no matter how much the patient weighs. The factors that can alter the results of breast implant surgery are an ulterior pregnancy or the natural aging process.When the breast augmentation with implants is performed, the plastic surgeon will create incisions (either in the axilla, inframammary fold, or around the areola) and create a pocket under the mammary gland, under the pectoral muscle or in a dual plane. The implants will be inserted into this pocket created to accommodate them, and then the incisions are sutured.The patient can also leave the medical facility within hours, and the recovery period is no longer than two weeks. The pain can be more intense after breast implant surgery due to the sectioning of the breast tissues and the muscles. Also, the tissues of the breasts are stretched after the implant is inserted and this can create a feeling of tension on the breasts. Just like in the case of fat transfer, pain medication will be prescribed by the plastic surgeon to help alleviate the discomfort.ConclusionFat transfer and implant surgery are both procedures that can be used to enhance the breasts. Even if performed with the same purpose in mind, the procedures are very different and provide different results. The fat transfer can provide natural results, but the increase in size is no more than half a cup to a cup. By using implants, we can achieve a more significant augmentation. The results of the fat transfer are dependent on the patient’s commitment to maintaining a constant weight. The results of breast implant surgery can also be negatively impacted by an ulterior pregnancy.