Breast augmentation is one of the most common cosmetic surgery procedures. There are many different ways of performing breast augmentation. Probably 99% are performed using implants. These could be silicone or saline (salt water), they can be round or tear drop shaped (anatomic) and they can be placed above or below the muscle. Finally, the implant can be inserted through an incision under the breast, through the nipple, or through the armpit. Sometimes an incision in the belly button can be used.
Aside from implants, there are very few surgeons who do fat injections instead of implants. This is associated with many potential problems. First, it is a very tedious procedure. There is a limit to how much can be done (you cannot expect a large increase in breast size with this technique). You may require multiple session. Finally, it is currently controversial whether or not it is a good idea to do fat injections into breasts because this can lead to small lumps that although completely harmless, can create a tremendous amount of anxiety in women who may be concerned about breast cancer. It is also unclear how much more complicated it is to screen these women for breast cancer. Studies are still ongoing, but at this time the American Society of Plastic Surgeons does not recommend breast fat injections for breast enlargement.
Another form of breast augmentation without implants is to transplant fat from another part of your body. This is a technique that has developed out of breast reconstruction techniques. In breast reconstruction after mastectomy, microsurgeons (a subspecialty of plastic surgery) are able to transplant fat from another body area (usually abdomen) to recreate a breast shape. In healthy women who have not had a mastectomy, this technique can be used for breast enlargement. The downside of this surgery is that it is very complicated. There are very few people in the world who can perform this procedure and because of it’s complicated nature, there is a risk of failure.
Finally, in a very select group of patients with droopy breasts, the breast tissue can be rearranged to create the effect of a breast augmentation. In effect, the patient has a breast augmentation without an implant. Unlike the previous two non-implant procedures, this procedure is very safe, has minimal risks, and the risk of failure is also minimal.
For more information about implant-free breast augmentation, please contact Dr. Jugenburg at The Plastic Surgery Clinic (http://www.theplasticsurgeryclinic.com) (http://www.plastica.ca)
Martin Jugenburg,MD, FRCSC
Toronto, ON
