Fat augmentation has recently been promoted as a “natural “ alternative to silicone breast implants. Whilst fat transfer has been used for filling minor defects in breast reconstruction for some time, it’s role in primary breast augmentation remains somewhat controversial. Indeed, there are fears that fat transfer may mask the mammographic assessment of breast cancer.
There have been a number of studies out of the US that have promoted fat transfer as a primary means of breast augmentation. However, the results have been difficult to replicate. One of the problems is that it is difficult to guarantee an actual breast size and the final results have been somewhat underwhelming.
The operation may have to be repeated 2 or 3 times to achieve the desired result. Using conventional fat transfer techniques, overall fat graft survival is only in the order of 30- 50%. The fat transfer can often end up lumpy to palpation for some months. It is also difficult to cost fat transfer operations which is problematic when the outcome can’t be guaranteed.