Since 2011, the FDA has been aware of a rare breast implant-associated anaplastic large cell lymphoma (BIA-ALCL), but only recently has it become national news.  It is a rare T-cell lymphoma that can develop following breast implant placement. The exact number of cases remains difficult to determine due to significant limitations in world-wide reporting and lack of global implant sales data. At this time, most data suggests that BIA-ALCL occurs more frequently following implantation of breast implants with textured surfaces rather than those with smooth surfaces.

This news is clearly a PR disaster for the makers of silicone implants, who have in the last decade clawed back consumer confidence with the FDA’s approval of silicone implants in 2006.  I often get asked, what are the alternatives to breast implants for enhancing the breast volume?  My answer is FAT, FAT, FAT!! With this setback for silicone, it time to examine fat transfer to the breast and its increasing popularity.  In 2016, fat grafting to increase breast size shot up 72%, according to an ASPS press release.  In contrast, using fat to augment the buttocks increased 26% last year.

However, most of the women I bring up fat transfer with as an alternative to breast implants are not excited about the idea.  They are worried that their breasts will shrink if they lose weight.  Let’s be honest, no one loses weight.  It is something we constantly wish for but which rarely happens.  If she loses weight, the patient’s breasts may lose some volume, but if she gains weight it will make her breasts bigger, so I think it’s worth the possibility of weight fluctuation.  Odds are good most patients will gain weight over time rather than lose weight.

With fat transfer augmentation, there is still a noticeable result that looks more natural than implants. On average patients usually end up retaining about 70% of the injected fat. Below is a photo of an actual patient of mine who desired a subtle enlargement. The “after” photo taken post recovery shows that fat transfer procedures are capable of producing results women would be highly satisfied with.

For fat transfer, there are other benefits when compared to breast implants. The incisions are smaller, the downtime is less (3 days versus 3 weeks), there is no risk of implant rupture or hardening.  In the past, there was concern that on mammograms the transferred fat could create artifacts that might be confused with cancer and lead to unnecessary breast biopsies.  Radiologists reviewing mammograms now feel more comfortable distinguishing these two types of findings and unnecessary biopsies are very rare.

Additionally there is the obvious benefit of the LIPO!!! Making another area smaller in order to enhance a desired body part is what made the Brazilian Butt Lift famous!  The fat is purified and reinjected, usually with injecting more fat than is needed since 30% is reabsorbed.  The patient now has a new area in which to store their fat.  Wouldn’t you like to dictate where you keep your storage?  Consider fat transfer instead of implants to enhance the breast, it has many benefits and few drawbacks.

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