Breast Implants VS. Breast Fat Grafting Which One is Right for Me?

Published: September 21, 2023
Category: Breast Augmentation, Breast, Dr. Christine Stewart, General

According to the International Society of Aesthetic Plastic Surgery’s (ISAPS) annual Global Survey on Aesthetic/Cosmetic Procedures, breast augmentation remains the most common plastic surgical procedure for women worldwide. In 2022, over 2 million women chose to enhance their appearance and confidence with breast implants. That is a 29% increase over 2021. It is not hard to understand breast augmentation’s enduring popularity — the placement of breast implants can increase self-esteem and confidence, restore the body after pregnancy or weight loss, reverse the effects of aging, improve the fit of clothing, and impact gender identity.

“The satisfaction rate from breast augmentation surgery is extremely high,” says Dr. Christine Stewart, a board-certified plastic surgeon and partner with Edina Plastic Surgery. “Many women consider their breasts a source of femininity and take great pride in their bodies, so it is entirely understandable that anyone unhappy with their breasts may seek a procedure to improve this insecurity or dissatisfaction. Now, more than any other time in history, women have more options for enhancing the fullness and shape of their breasts, including breast fat grafting. It’s important that they know and understand their options to decide which type of augmentation is best for them.”
Breast Augmentation with Implants

Breast augmentation surgery, also called augmentation mammaplasty, uses implants to restore or enhance the size and shape of a woman’s breasts.

“We live in a day and age, thankfully, that is growing to appreciate the beauty of all different body shapes and sizes,” says Dr. Stewart. “But, regardless of how body-positive a woman is, she may be unhappy with her breasts if they are asymmetrical or disproportionate to the rest of her body. A breast augmentation can change the size, shape, and even the projection of her breasts to help her feel more confident and feminine.”

Breast augmentation surgery relies on saline or silicone implants to enhance a woman’s breasts. At Edina Plastic Surgery, your plastic surgeon will work with you to determine which type of implant, as well as what size and shape, will best suit your needs and aesthetic goals.

Saline Breast Implants

“The primary advantages of saline implants are that they are less expensive than silicone and do not require imaging, like ultrasound, to detect when leakage occurs,” explains Dr. Stewart. “The filling of a saline implant is a sterile saltwater solution. This makes the occurrence of an implant rupture very obvious, as the body reabsorbs the fluid and the implant visibly flattens. The downside of saline implants is that they are more prone to rippling and may feel less natural.”

Silicone Breast Implants

As the name suggests, silicone implants are filled with thick, 5th generation medical-grade silicone. The 5th generation designation means that the silicone acts more like a solid than a liquid and is “form stable.” This characteristic makes silicone implants less prone to rippling, which is essential for thinner women or those with small breasts to achieve a natural result.

“5th generation silicone implants are also what people commonly refer to as “gummy bear” implants,” says Dr. Stewart. “They are generally more expensive and are frequently preferred by patients to saline because of their natural look and feel. The downside to silicone implants is the need for monitoring for “silent rupture.” When silicone implants rupture, because they are made out of a solid material, it is not easily detected on physical exam, even by a plastic surgeon. If the rupture remains undetected for a long time, capsular contracture can result. Silicone breast implants are FDA-approved for patients over the age of 22.”

Silicone implants come with additional maintenance to monitor the implant for rupture. Currently the FDA recommends an ultrasound 5 years after implantation and then an ultrasound every 2 years after that. Once an implant rupture is detected, follow-up should be made with your plastic surgeon to determine next steps. In 2019, the FDA changed screening imaging techniques from an MRI to an ultrasound due to ultrasounds being more readily available to patients in various areas of the country and due to the reduced cost.

Are Breast Implants Right for Me?

Every patient has their own reasons for undergoing a breast augmentation with implants. Here are some of the most common reasons patients at Edina Plastic Surgery express to our plastic surgeons.

  • My small breasts feel disproportionate to the rest of my body.
  • My breasts are so asymmetrical.
  • My breasts seemed to have deflated entirely after pregnancy, breastfeeding, or weight loss.
  • My breasts are so flat on top. I wish they were fuller to match the lower part.
  • My breasts are just beginning to sag.
  • My breasts are smaller or asymmetrical due to a prior surgery or trauma.

Breast Fat Grafting

“Breast implants used to be the only show in town when it came to breast augmentation surgery,” says Dr. Stewart. “But even with all of the advancements in implant technology over the past decade, they still can’t perfectly imitate the look and feel of natural breasts. For this reason, breast augmentation with fat grafting has become increasingly popular over the past few years. Instead of using a synthetic, artificial device to mimic a fuller or rounder breast, fat transfer, or “grafting,” uses natural tissue from a patient’s own body to add shape and volume to the breasts.”

During breast fat grafting, fat is harvested from the abdomen, flanks, thighs, buttocks, arms, or a combination of areas via liposuction. It is then processed and refined to remove blood, oil, and saline. The refined fat tissue is then injected into the breast to sculpt it into the desired shape and size. One limitation of breast fat grafting is that a patient must have a BMI of at least 25 for enough fat to be harvested for breast fat grafting.

Is Breast Fat Grafting Right for Me?

“Breast fat grafting is an excellent option for patients interested in a more natural alternative to implants and do not want anything foreign in their body,” says Dr. Stewart. “Keep in mind that fat grafting results are far more subtle than implants. Only a volume increase of ½ cup to 1 cup size can be achieved with this method. The shape you can attain with fat grafting will also appear more natural. It will not give the upper pole fullness to the breasts that implants will. So, it’s important to clearly understand your aesthetic goal when deciding between breast implants and fat grafting. Patients who are good candidates for fat grafting maintain a relatively stable weight within 5-10 lbs. The fat transferred is still responsive to metabolic change, so weight loss or weight gain cause the fat graft to either shrink or grow. ”

Here are some of the most common reasons patients at Edina Plastic Surgery express interest in breast augmentation with fat grafting.

  • I want a more natural option than implants.
  • I do not want anything synthetic or foreign in my body.
  • I just want a little more volume in my breasts.
  • I want the shape of my breasts to look as natural as possible.

“I would encourage patients to explore all of their options when it comes to breast augmentation and match them up against their aesthetic goals and lifestyle to determine which is best for them,” advises Dr. Stewart. “Fat grafting will never fully replace implants because the advantages of each are unique. In fact, fat grafting can even be performed WITH breast implants in some cases where your plastic surgeon may think it’s beneficial. Remember, your plastic surgeon is here to discuss all of your options to help you determine the best approach to help you reach your goals!”

Are you interested in enhancing the shape or size of your breasts with implants or breast fat grafting? Schedule a complimentary consultation with Dr. Christine Stewart or another board-certified plastic surgeon at Edina Plastic Surgery by calling (612) 688-3168, texting (952) 925-1765 or CLICKING HERE!

Schedule A Consultation