Breast Augmentation: Fat Injection or Silicone? – Mythbuster Monday

You may remember a couple of months ago when we discussed the difference between fat and artificial facial injections. Just like artificial fillers are better for longevity and satisfaction—silicone breast implants are better than fat injections for breast augmentation. However, there are situations where fat augmentation can be used in conjunction with silicone implants, such as a breast reconstruction after a mastectomy.

Fat Augmentation of the Breasts is Risky

Fat augmentation of the breasts seems like a great idea because it’s a “natural” procedure, but the risks outweigh the benefits. Often called “stem cell breast augmentation,” neither the safety nor efficacy of this procedure is supported by scientific evidence. The American Society of Plastic Surgeons commissioned a taskforce in 2011 to examine the scientific support of stem cell use, and concluded that there is not enough evidence to fully support the procedure.

The negatives of fat augmentation lie in both the procedure and the outcome. Most people who opt for a fat augmentation procedure don’t realize it requires two procedures – one to remove the fat from some other area of the body, and one to inject that fat into the breasts. Because this method requires surgery on two different areas, overall healing time increases.

The outcome of a breast augmentation by fat injection is extremely unpredictable because of the nature of fat cells. Fat cells need high blood flow to survive, and if there isn’t enough blood, the body reabsorbs the cells. Since there is a potential for reduced blood supply, fat augmentation is risker for women who desire a 2-3 cup size increase.  In the best circumstances, the breast will retain around one cup size worth of fat. There is also a risk of asymmetry because of varying absorption rates between the left and right sides.

Fat Augmentation for Post-Mastectomy Reconstruction

During a mastectomy, many times the surgeon has to remove skin, fat and the nipple. Because of this, if the reconstruction only includes a silicone implant, the edges of the implant can be seen. This also can cause ridges in the upper pole of the breast (the part of the breast above the nipple, on the chest wall).

Using a combination of fat augmentation of the breast and a silicone implant, a post-mastectomy reconstruction can look more natural and full. Fat injections will make the breast look softer by filling in the space where the edges and ripples would normally be seen.

Silicone Implants are the Better Choice

Beginning in the 60s, there were concerns about silicone breast implants because of the risk of leaking. In 1992, the FDA halted the sale of silicone implants while more research and improvements were made. After over 10 years of experimentation and improvements, the FDA began supporting silicone implants in 2006 because developments in technology made them safer.  New silicone implants have stronger shells and the gel used inside the implants is a type of “memory gel” that doesn’t leak out of the implant if that shell is compromised. Most silicone implants have a lifetime warranty as well.

A silicone breast implant procedure takes only one hour, and the healing time is less than the fat harvesting/augmentation procedures. Not only is the procedure much less stressful on your body, but the efficacy of silicone implants is predictable. In conclusion, it is clear that silicone implants are a better choice TODAY than fat augmentation injections. As there is more understanding of fat cells and their survival in the future, fat augmentation may become the best option — but we are not there yet. Of course, a board certified physician’s discernment should be considered when making any sort of surgery decision. If you are considering breast augmentation, Dr. Panchal is happy to meet with you and help you choose the right type and size for your body.


Eaves, F., Haeck, P., & Rohrich, R. (2011). ASAPS/ASPS Position Statement on Stem Cells and Fat Grafting. Plastic and Reconstructive Surgery, 285-287.

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