Introduction Many women care much about their physical appearance especially the size of their breasts, which has been commonly associated with sexuality and femininity. Small breasts, overly large breasts, asymmetrical breasts can greatly affect self-esteem and confidence, which can have a debilitating and highly negative impact on a woman’s personal and professional life and overall mental and emotional health. While there are women who request for breast reduction or breast lifting procedure, the most coveted breast intervention is undoubtedly the breast augmentation surgery. While silicone implants are the traditional methods of breast augmentation, it is not necessarily the most requested procedure by women since a number of plastic surgeons also recommend less invasive breast augmentation methods such as autologous fat transfer. An alternative to achieve beautiful breasts without silicone implants Yes, you can add shape and volume to your breast without implants, but, the first condition to be eligible for breast augmentation with fat transfer is to have, at least, a donor area. The donor area is an area or areas of your body with excess and unwanted fat deposits. This means that the intervention is performed in two stages: the first stage entails harvesting the fat from the donor areas and the second is reinjecting the purified fat into the breasts. During the first stage of the procedure, the plastic surgeon will focus on extracting the fat from the donor area or areas (usually the abdomen, flanks and thighs) via liposuction. Once the required amount of fat is collected, is goes through a purification process that produces pure fat, which are then injected to the breasts. As a rule, the plastic surgeon should not inject more than 200 ml of pure fat in one session. The patient who wants more voluptuous breasts will have to repeat the procedure after a given period. The breast augmentation with fat transfer is practically a scar less intervention and it is considered a less traumatizing procedure for the breasts compared to the silicone implant surgery. The only incisions performed during procedure are those in the donor areas and are no longer than 4 mm in diameter. The augmentation of the breasts using the patient’s own fat is the ideal solution to correct mild breast ptosis (breast sagging). It has been clearly demonstrated by previous successful procedures since 2009, that fat transfer can enhance and give a natural looking shape and volume to the breasts, as well as deliver a mild lifting effect on the breasts. It is also a safer alternative to silicone breast implants as it eliminates the risks and complications normally associated with silicone implants. The benefits of breast augmentation with autologous fat transfer The main advantage of the procedure is using live cells from your own body. During this intervention we are not injecting foreign substances into the body, nor placing silicone implants. Therefore, there is no risk of the body rejecting its own fats or having allergic reaction to it. The augmentation of the breasts looks natural and almost scar- free. There are no incisions in the breasts; the only marks left are tiny incisions from liposuction in donor areas. The results of the procedure can be easily sustained for a long time if you maintain a stable weight and a healthy lifestyle. It is a win-win outcome! You get shapelier and bigger breasts combined with a slimmer silhouette resulting from the removal of excess fats in donor areas. Put simply, by opting for fat transfer to the breasts, you get the added bonus of eliminating unwanted fat deposits on your body. Some plastic surgeons choose to set the price of the intervention based on the number of donor areas. Personally, I don’t believe this is a viable plan as it defeats the purpose. To be able to perform the augmentation, fat is required. It is the surgeon’s responsibility to address areas with sufficient fat deposits to be able to harvest the necessary quantity of fat to give the breasts its desired shape and volume. The plastic surgeon will not remove fats from the chin or calves or the upper arms with liposuction. If these areas have aesthetic imperfections, they will be dealt with separately as they will certainly not be able to provide sufficient amount of fat needed for transfer to the breasts. This plastic surgery intervention can be used to augment the size of the breasts, to correct defects or imperfections of the breasts, and to improve the contour and aspect of the breast after partial removal of the breast or lumpectomy. Do note that the procedure cannot increase the breast to more than a cup size in one sitting. Further, the results of the intervention are dependent on the quantity of fat available for use in fat transfer. Disadvantages of the breast augmentation with fat transfer The main worries associated with the fat transfer to the breasts are basically the low survival rate of the transferred fat cells, which are also frequently reabsorbed by the body over time, and the risks of calcification, cysts formation and scarring within breast tissue. Conclusion There is no doubt that the silicone breast implant surgery always delivers impressive results for all types of patients. The growing popularity and interest in breast augmentation has also led to the development of new, less invasive techniques that would still be able to deliver aesthetically pleasing shape and volume to the breasts. The fat transfer to the breasts is a relatively new plastic surgery procedure designed to add volume and shape with fewer scars and shorter recovery period. No more than 200 ml of purified fat can be safely injected during one session. Patients looking for a more immediate and impressive enhancement can opt for breast implants or to repeat the autologous fat transfer procedure multiple times. The breast augmentation with fat transfer comes without the risks and possible complications normally associated with the breast implant surgery. During the procedure, the plastic surgeon only uses the patient’s own fat to augment the size of the breasts. Because no foreign objects or substances are introduced into the body, there is no risk of rejection or adverse reaction of the body.