Not everyone who wants enlargement of the breasts wants a breast implant. They are foreign bodies and are therefore more prone to problems like scar tissue contracture, infection, rippling, and unnatural appearance. An option would be to use your own body’s tissues – fat for example – or something else that is very similar. This is actually being done in Europe with breast injection of hyaluronic acid, a normal component of our skin. Hyaluronic acid is the active ingredient in Juvederm and Restylane that are used for facial injections. Although this type of breast enlargement is not permanent, this technique may be ideal for the woman who needs a quick boost for a beach vacation!

What about the use of your own body’s fat to give a permanent breast enlargement? The earliest breast augmentation was actually done in this way. In 1865, a German surgeon removed a lipoma – a fatty tumor – from a woman’s back and implanted it into her breast. Because it lacked a blood supply, the lipoma did not survive. More recently doctors have been removing fat and injecting it into breasts. This fat is suctioned out by means of a modified liposuction technique, purified, and injected. The injection places the fat into tiny tunnels within the breast that allow blood vessels to grow into the fat and nourish it. Approximately 60% of the fat survives, making 1-1 ½ cup size breast enlargements possible. Even slender women can undergo this procedure, provided that some excess fat can be found. Frequently the thighs provide the source for the fat, allowing for a moderate breast enlargement as well as body contouring with the liposuction.

A concern with this fat injection technique for breast augmentation has been the appearance of small calcifications in the breasts when some of the fat fails to survive. Can these be distinguished on mammogram from the calcifications that occur in breast cancer? The answer seems to be yes. In fact, one of the best uses for fat injection for the purpose of breast augmentation is in women who are undergoing reconstruction following breast surgery for cancer. Although fat injection alone cannot completely reconstruct a missing breast, it can be used to add fullness to deficient areas after the major reconstructive work is done.

In many cases a woman who wants breast augmentation with fat injection has a very tight breast. The BRAVA system can be used to stretch the breast tissue over a period of weeks to months to prepare the breast for fat injection. The BRAVA system is an appliance that is worn over the breasts for a portion of each day. It places a suction force on the breast, stretching it and actually causing a limited degree of breast growth. Once the skin and breast tissues are looser, the fat can be more readily injected.

Is fat injection a substitute for augmentation with implants? No!! The enlargement is less than most of my patients want and the look may be a bit too natural. In cases of rippling or a desire to add additional fullness to an area that the implant cannot fill, however, fat may be a useful adjunct to implant surgery.

Should you desire further information, please contact my office.