Pros and Cons of Autologous Breast Augmentation

Some people like the idea of having bigger breasts but don't like the idea of breast implants. Breast augmentation with fat is technically known as autologous breast augmentation. This procedure uses your own fat instead of implants to increase the size of the breasts. The fat is liposuctioned from another body area and injected into the breast.

According to the Aesthetic Society, more than 22,000 people received autologous breast augmentation (also called breast fat grafting) in 2021.

The main benefit of this type of augmentation is that there is no implant, so the breasts feel more natural. Also, this type of surgery tends to have fewer complications. On the other hand, the downsides include limitations in cup size, the inability to lift sagging breasts, and potential issues with breast screening going forward.

This article explores the benefits and drawbacks of autologous breast augmentation.

An illustration with the pros and cons of autologous breast augmentation

Illustration by Joules Garcia for Verywell Health

About the Procedure

In the past, the American Society of Plastic Surgeons (ASPS) did not recommend using fat to enlarge breasts. In 1987, the ASPS said the side effects could make it harder to screen for breast cancer. Side effects of autologous augmentation can include:

  • Dense or hard lumps
  • Oil cysts, which are growths filled with liquid fat
  • Calcifications, which are bone-like specks
  • Infection
  • Fat necrosis, which is the death of fat cells due to a lack of oxygen

At that time, plastic surgeons stopped performing the procedure. More recently, the ASPS Fat Graft Task Force has stated that the procedure may be useful in some cases.

The procedure is also called "stem cell breast augmentation." This label is misleading. A stem cell can develop into different types of tissue based on where it is placed in the body. Fat does contain stem cells. However, stem cells alone cannot be injected into the breast to increase breast size. They must be combined with fat.

Before you decide to have this procedure, it's important to understand the possible long-term effects of fat transfer to the breast.

Pros
  • No implant used

  • Small incisions

  • Uses your own fat

  • Lower complication rate

  • Breasts look and feel natural

  • Good safety record

  • Patients and doctors are satisfied with the results

Cons
  • No standard technique

  • Only enlarges one cup size

  • Breast lift may still be needed

  • Fat may be reabsorbed

  • Calcifications may interfere with breast cancer imaging

  • Must have enough spare fat to transfer

  • Fat necrosis (small hard masses which look like cancer) may be permanent

Advantages

During the procedure, fat is suctioned from another part of the body and injected into the breasts.

The benefits include:

  • No implant is needed
  • Breasts look and feel normal
  • A small incision (cuts made to remove and re-inject the fat are only 4-millimeter long)
  • Benefits for mildly sagging breasts
  • Good rate of success
  • Most people are happy with the results

The procedure has a good track record when used to enlarge healthy breasts. It has fewer complications than implant surgery. And fewer people end up needing another operation later.

Case reviews have found that most people and their doctors are happy with the results. And for people who have had breast surgery to treat cancer, studies have found that autologous augmentation does not raise the risk of cancer returning.

Disadvantages

Still, there are some disadvantages to autologous breast augmentation. Surgeons have published detailed descriptions of how to remove and inject fat to increase breast size. But there is no standard technique for the procedure.

For this reason, you'll want to find a surgeon with a successful track record with this procedure. It is also important to know what the procedure can and cannot do.

Other disadvantages include:

  • Cup size limitation
  • Can not lift sagging breasts
  • Fat injection can make breast cancer detection difficult
  • You may not have enough excess fat for the procedure
  • You must be self-motivated

With autologous augmentation, your breasts will only increase by about one cup size. That's because the tissue expander (a pocket for the fat) only supports a limited amount of fat. So at most, an A-cup breast will increase to a B-cup. With breast implants, there is no such limitation.

Your surgeon may rely on you to manage an external expander before the procedure. Self-motivated people tend to have better results, especially with self-directed expansion.

Because fat does not have its own blood supply to keep it alive, it uses the blood supply already in the breast. That's why a limited amount of fat can be injected.

If too much fat is injected, it will be reabsorbed. That means the breast size can shrink again. Unfortunately, it's also possible for the fat to harden.

In addition, not everyone has enough extra fat for this procedure. To effectively increase breast size, the surgeon must harvest at least 1,000 milliliters of pure fat.

Fat Transfer vs. Implants

Fat transfer is only one type of breast augmentation. Other methods include:

  • Saline breast implants: These implants are filled with sterile water and are FDA-approved for people over 18.
  • Structured saline implants: These have an inner structure, making them feel more like natural breast tissue.
  • Silicone breast implants: These implants are filled with silicone gel that feels more like natural breast tissue. They are FDA-approved for those over 22.
  • Gummy bear breast implants: A type of silicone implant that is thicker and firmer and maintains its shape even when the shell breaks.
  • Round breast implants: These are the same shape all over, which limits their ability to roll out of place. They tend to feel softer and have more natural movement.
  • Textured breast implants: These implants rely on scar tissue that sticks to the implant, making it less likely that the implant will move out of place. These are no longer used in the U.S. because of their link to cancer.

While breast implants offer greater sizing and lifting options, they carry some risks. According to the U.S. Food and Drug Administration (FDA), implants may cause breast pain desensitization, plus you run the risk of breast implants rupturing or deflating. In some instances, you may have trouble breastfeeding after receiving implants. In addition, breast implants—mostly textured—are associated with a type of non-Hodgkin's lymphoma (BIA-ALCL).

How Much Does It Cost?

Like all procedures, the price of autologous breast augmentation varies based on your situation, where you live, and the surgeon you choose. However, the average cost is around $10,000.

Summary

Autologous breast augmentation is a procedure that enlarges breast size by injecting your own body fat into the breasts. The procedure usually works well and has few complications.

The procedure has several advantages. First, it uses your own body fat instead of an implant. Also, it requires very small incisions, and the breasts usually look and feel natural.

There are some downsides to consider. One is that your breasts will only be about one cup size larger. Another is that you might still want a breast lift because injecting fat won't tighten loose breast skin. It's also possible for calcifications to form, which may complicate breast cancer screenings down the road.

Not everyone is a good candidate for this procedure. You might want to discuss other options with your plastic surgeon if you have very little body fat.

9 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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  5. Vyas KS, DeCoster RC, Burns JC, et al. Autologous fat grafting does not increase risk of oncologic recurrence in the reconstructed breast. Ann Plast Surg. 2020;84(6S Suppl 5):S405-S410. doi: 10.1097/SAP.0000000000002285.

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Additional Reading