Should I
Get Breast Implants or Fat Grafting? – That Is the Question
When
considering breast augmentation or enlargement surgery, implants are no longer
the only options. There is also the possibility of using the fat transfer
techniques for natural or organic breast augmentation. With the option to
choose between the two, anyone who is considering a breast augmentation
procedure needs to think about which option might be better suited to the
results that they want. Fat transfer isn’t always the right choice, and
implants could be the better option for some people. Both implants and fat
transfer have pros and cons, which should be explored before deciding which
procedure might be best for your breast augmentation.
What Is
Fat Transfer?
Fat transfer
is an “organic” method augmenting the breasts by harvesting fat from another
part of your body for example your thighs and tummy. The procedure starts with
liposuction techniques to harvest donor fat from an area of the body with
excess fat. The fat cells are then washed, centrifuged and purified before
being reinjected into your breasts (or another part of the body that you want
to augment – fat grafting is also an alternative for facial volumization with
fillers). This means that you can both remove excess fat from an area which you
would like to reduce and augment your breasts or another body part (such as
your butt in the Brazilian Butt Lift) at the same time.
The
Advantages of Implants
Using
implants offers a number of advantages for augmentation. Breast implants offer
excellent shape and projection which is unmatched with fat grafting alone. It
could be the best choice for those who want to enlarge or lift their breasts.
Size and
Shape
Choosing
implants means that you can select a size and shape that suits you. You are
only limited by the implant sizes & dimensions that are available, whereas
if you choose fat transfer, the amount of fat that you have makes a difference
(Disadvantage in slim or thin women as they have less fat for harvest).
Safety
When it
comes to the safety of implants, breast augmentation surgery is something that
has been carried out and tested for many decades. Although there have been
safety concerns related to certain types of older implants, this has mostly
been related to poor quality implants or incorrect insertion & technique or
sterility. They are generally regarded as being very safe, especially with newer
type of microtextured implants to choose from such as Polytech, Lifesil &
Motiva.
Implant guarantee | POLYTECH Health & Aesthetics (polytech-health-aesthetics.com)
Longevity
Another
advantage of breast augmentation with implants is how long they last. The
lifespan of breast implants should be between around 15 to 20 years before they
need to be replaced. Unless you experience any complications, they need not be
replaced any earlier than this.
Price
Implants can
be the less expensive option when compared to fat grafting. This is because fat
transfer requires two procedures to first harvest the donor cells and then
inject them, whereas implants require only one procedure. Furthermore, some breast
envelope pockets are tight necessitating a second fat grafting procedure after
the initial expansion. Some grafted fat is also lost (about 20-30% of fat is
lost by resorption) after surgery. We use Stromal Vascular Fractionate (SVF)
and Platelet Rich Plasma (PRP) to enhance the fat graft survival in our surgeries
leaving our fat grafting ‘take’ to be between 70- 80%.
The
Disadvantages of Implants
Implants can
also have a few drawbacks that should be considered when one decides between
implants or fat grafting for breast augmentation.
Today, implants can be made to look very natural, especially when you choose the right type of implants and technique used by the surgeon (I prefer using a dual plane placement of implants and sometimes perform hybrid breast augmentation combining breast implants and fat grafting in the same surgery). However, some women with very little soft tissue coverage over their breasts who undergo breast augmentation with implants alone may have some rippling and slightly unnatural appearance such as less cleavage.
A hybrid breast augmentation – implant combined
with simultaneous fat grafting will be indicated in such situations but can
pose a problem for patients with budget constraints.
You may read
more about Hybrid Breast Augmentation here.
There is
also a very small risk of implant capsular contracture. Your body builds a
“capsule” around each breast implant. The capsule is made from interwoven
collagen fibers, or scar tissue. In some cases, the capsule tightens over time.
This is called capsular contracture. When this happens, the collagen “fabric”
around the implant shrinks due to a buildup in fibers. This tightening can
squeeze the implant, making it feel hard and painful to touch. The incidence of
capsular contracture is very low if correct technique which is surgeon
dependent.
https://www.youtube.com/watch?v=d19GjJ6ymxk
To prevent
capsular contracture, I do not use breast sizers during the surgery as this can
increase trauma & contamination leading to higher rates of capsular
contracture. I published this study https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4820630/
with world famous plastic surgeon Ivo Pitanguy who was also my Program Director
during my plastic surgery training in Brazil.
You may read
more about the Founding Father of Plastic & Reconstructive Surgery, Ivo
Pitanguy here.
https://drkhooleesengplasticsurgery.blogspot.com/search/label/Ivo%20Pitanguy
I also use
the Keller’s Funnel to decrease contamination and trauma during implant
insertion ultimately leading to lower rates of capsular contracture.
The
Advantages of Fat Transfer
Fat transfer
also has some excellent advantages that might tempt you to choose it over the
traditional augmentation method of implants.
For many
people, the appeal of fat transfer is that it is more natural. Not only does it
mean you won’t have any foreign material in your body, but it can create a
softer more natural-looking augmentation too. However, it is still a major
procedure, even if it is sometimes called natural breast augmentation.
Another
benefit of fat transfer is it can address two concerns at once. If you want to
augment one area but also reduce fat in another area, this procedure can help.
You can remove fat where it’s unwanted and inject it into your breasts or
another area where you want to increase the size, volume or shape.
Fat transfer
is still a major procedure, but it is less invasive compared to implants. It
does not require the incisions that are required for inserting implants.
In
circumstances when implants may not be required, fat transfer can be a good
choice. It is ideal for evening up uneven breasts or restoring the shape of a
breast after a lumpectomy or in breast reconstruction.
The
Disadvantages of Fat Transfer
Fat transfer
has its share of drawbacks, which are important to understand before going
ahead with the procedure.
Fat transfer
can work out if you are looking for modest results. However, if you’re thinking
about enhancing your breasts more than half a cup size or so, implants are
likely to be better. You are also limited by how much fat you have available to
use from other parts of your body.
While
implants can last for many years, the results of a fat transfer might not last
as long. The fat cells that are transplanted could be absorbed into the body if
you diet or lose weight.
Price
Overall, a
fat transfer will cost you more than implants. It involves both liposuction
techniques and injecting the harvested fat cells into the desired area. While
these things can be done with local anesthetic and as an outpatient procedure,
it can still be more expensive than implants. You may also require 2 to 3
sessions of fat grafting to expand the breast envelope to allow you to achieve
the cup size that you desire.
The fat
transfer method might not always be suitable in very thin or slim women. It
works best for anyone who has some extra fat that they can use in another area
of their body. If you are particularly slim or thin, you will probably find
that you don’t have the necessary fat cells to harvest. It’s also not suitable
for anyone who wants to go up by more than around a cup size.
Risks
Fat transfer
might be referred to as natural augmentation, but it’s still a serious
procedure with risks. It’s a newer procedure compared to implants, so the
safety issues aren’t as well explored. It is a safe procedure, but it’s still a
surgery that comes with some risks.
When to
Use Implants
When should
you choose implants for breast augmentation, or to enhance other parts of your
body? Implants are probably the best choice if you want to increase the size of
your breasts by more than half to one cup size. This is more difficult to
achieve with fat transfer. Implants are also the better option if you are looking
for more long-term results. Implants will last for a long time, and you can
wait for 15 to 20 years before you need to consider replacing them. Choosing
implants could also save you money too, especially as they last for a long
time.
When to
Use Fat Transfer
Fat transfer
could be a good option for people who want to both remove fat in one area and
enhance another area. It is ideal for women who want a more natural or subtle
change, as it’s used to make a smaller change. It might also be right for those
who want to even out uneven breasts or want to smooth out changes after a
lumpectomy. If implants seem too big of a change or you want to keep things
subtle, fat transfer could be the right option.
Whether you
choose implants or fat transfer, it’s essential to have the right surgeon with
ample experience with breast augmentation and liposuction & fat grafting.
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Sincerely yours,
Dr Lee
Seng Khoo
