When looking for plastic surgery procedures to enhance the appearance of their breasts, many women are confronted with the choice between breast implants and fat transfer to the breasts. The procedures are very different and provide different results. Breast implant surgery can significantly increase the size of the breasts while fat transfer can only provide a moderate augmentation. For women who want a discreet improvement in the size of their breasts, both options can be considered. The level of post-op pain, the length of the incisions, and the complications associated with each procedure are important factors that should be taken into consideration before making a decision toward one procedure or the other. In this article, we will discuss whether breast implant surgery is associated with a more intense level of pain compared to a fat transfer to the breasts. But first let’s see what each procedure entails. Breast implant surgery When prostheses are used to increase the size of the breasts, incisions need to be made. The length of the incisions depends on the type of breast implant used. For saline solution implants, the incisions are smaller as the implants are filled with solution after they are inserted into the breasts. For silicone implants, the incisions need to be bigger as they come prefilled with highly cohesive silicone gel. The incisions can be placed either around the areola, in the inframammary fold, or trans axillary. The implants can be positioned either behind the mammary gland or the pectoral muscle. Each and every one of these surgical decisions is important when it comes to determining the level of pain the patient will experience after the surgery. Generally speaking, implants positioned behind the pectoral muscle can lead to a more painful recovery period as the muscle has been injured and needs to heal. If the implant is placed behind the mammary gland, it is only the soft tissues that heal during recovery, so the pain is less intense. Fat transfer to the breasts This procedure starts with a liposuction performed on the donor area or areas. Once the necessary amount of fat is extracted, it goes through a complex purification process that delivers only pure, intact fat cells to be used for the transfer. For the transfer to the breasts, the plastic surgeon will use special syringes to inject the fat into the breasts in different areas and at different depths. The incisions performed for this procedure are incomparably smaller compared to the breast surgery procedure. This means less pain and discomfort during the recovery period. Pain after breast augmentation with implants and fat transfer Before anything else, it is important to mention that tolerance to pain is something that differs from patient to patient. Each of us feel pain in a different manner, and it can be generalized. However, for the same patient, we could say that the level of pain experienced after a fat transfer to the breasts is less intense than one that can occur after breast implant surgery. One of the advantages of the autologous fat transfer is that it is not a surgery by all definitions. The incisions are insignificant in terms of length, the bleeding is much reduced, and the injury of the tissues is less significant. Nowadays we are used to putting an equal sign between breast augmentation and breast implant surgery. Of course, breast implant surgery has countless benefits when it comes to achieving the desired shape and size for the breasts, but it also has some disadvantages that for some patients can be real turn-offs. Considering the fact that we are dealing with a prosthesis (an object that is foreign to the body), the simple use of implants can create more discomfort than using the patient’s own fat cells. Moreover, if the implants are big, the tissues will be stretched to accommodate it. This does not create more pain, but a burning sensation or tension that some patients might interpret as discomfort or pain. Fat transfer to the breasts is not associated with these side effects as both parts of the procedure (the liposuction as well as the transfer itself) only deal with the patient’s own fat tissue. The recovery period after both procedures is less than two weeks. After a fat transfer, the patient can resume work even within the first week post-op. After breast implant surgery, the patient is advised to avoid ample arm movement as it can trigger pain. The pain is not necessarily felt at the time when the movement was performed, but later on, usually in the evenings. The patient also needs to avoid any pressure on the breasts for more than a month after the procedure in both cases. Sleeping on the tummy is not recommended for at least six to eight weeks. The fat transferred to the breasts needs time to get blood supply. If additional trauma or pressure occurs during this time, it can cause the fat cells to die. Also, it is important to keep in mind that a significant percentage (up to 30-40%) of fat injected into the breasts can be reabsorbed by the body in the months following the procedure. Conclusion Fat transfer to the breasts and breast implant surgery are performed in different manners and have different goals, even if the common aim is to provide an increase in the size of the breasts. Depending on the surgical method chosen they can be more or less painful. However, the patient’s tolerance to pain is the factor that ultimately gives the intensity of pain. In most cases, patients who undergo breast implant surgery can experience more pain than patients choosing a fat transfer to the breasts.