Breast augmentation, either with natural tissue or an implant, always involves the addition of volume to the breast. Important goals are to improve proportionality of the figure overall, to balance the skin of the breast with the volume contained within, and to match implant base diameter (footprint) to the size of the chest.

There are currently three options for breast augmentation: gel silicone implants, saline implants, and autologous fat transfer (using the patient’s own tissues). The safest and most reliably successful augmentation results from the use of gel implants. These modern, FDA-approved implants do not contain any liquid, but are filled with a gelatin-like silicone polymer that is soft, natural, and resistant to folds and wrinkles. Breast augmentation results using these implants are natural and comfortable.

In contrast, saline implants are firm, show more wrinkles and ripples, and have the potential for deflation, especially as they age. Gel implants are well-tolerated when placed above the muscle for almost all women. Saline implants need more soft tissue coverage, making placement under the muscle more common, especially for slender women.

For some women, regardless of the type of implant chosen, half under and half over the muscle is appropriate, depending on anatomy and the desired end result. Under the muscle provides greater upper-pole fullness, sometimes at the expense of a less natural result.

Natural breast augmentation can be performed using skin flaps, such as from the abdomen or back, but this is a significant undertaking and is usually reserved for breast reconstruction after mastectomy. A less involved procedure utilizes fat grafts which are harvested during liposuction. While this may sound like a terrific idea, there are some significant drawbacks to this approach.

Transplanted fat is notorious for melting away, in some cases leaving as little as 30 percent of the initial amount for long-term survival. For this reason, it is common that the fat transfer process has to be repeated several times to achieve not only the desired volume but also the required symmetry.

Fat that is mixed with a patient’s own stem cells (so-called “adipose derived stem cells” or ADCs) has a much better track record in terms of survival after natural breast augmentation, but it is unclear how these very active and powerful cells interact with breast tissue over the long run. The biggest concern is the effect that ADCs may have on the development of breast cancer. Until there is more research, the use of ADCs with fat grafting for natural breast augmentation is not recommended.

For more information about breast augmentation methods, or to schedule a consultation with Board Certified Breast Surgeon Dr. Daniel Greenwald, contact Bayshore Plastic Surgery today at 888-840-3199 today.