Should I Use Fat Grafting or Implants for Breast Augmentation

Dr. Andrew Khoo

Plastic & Aesthetic Surgeon
FRCS (Edin), FRCS (Glasg), M Med FAMS (Plastic Surgery)
 T 6733 3712 | E info@andrewkhoo.com

A common request amongst our Asian patients is to augment their breasts. There are many methods to enlarge the breasts and this article will serve to help make that decision.

1. Breast Augmentation using Fat Grafting

Breast augmentation can be achieved using a natural filler material made from one’s own fat collections. This is known as fat grafting. Indeed, one of the most common requests from our patients is to make their abdomen slim and enlarge their breasts at the same time. In our hands we reserve this method for patients who need a moderate increase in breast size with good skin tone. They should have adequate fat collections for the proposed augmentation. This should be 2.5 to 3 times the proposed volume of fat to be injected into the breast. The fat is harvested from the abdomen, thighs or buttocks and is processed in a machine to thicken the aspirate. We use the Lipokit which selects the younger fat cells and concentrates the cells before we inject them into the breast. The breast is pre-marked so we can insert the cells into the particular area that we need them. This varies from patient to patient. The cells have to be inserted carefully in a threadlike manner to ensure their survival. This will ensure a long lasting result. This procedure is done in an operating theater under intravenous sedation or a general anesthesia as a day surgery. Sometimes, repeat procedures are needed.
2. Breast Augmentation with Silicone Gel Implants

Breast augmentation using silicone gel implants is recommended for larger augmentations. In our hands, this is usually for those needing more than 150 cc of augmentation in each breast. There are many types and brands of implants but, over time, we have found that our best results come from using Allergan cohesive silicone gel implants in an anatomical shape. This is because our Asian patients have little breast tissue of their own and tend to show the shape of their implants more than our Caucasian patients. As cohesive gel implants tend to be firmer, we like to use the soft touch variety of silicone gel implants. In terms of target size, this will be discussed but we tend to advise that the implant width should not exceed the breast width. This will avoid an unnatural “Bay Watch” look. A variety of incisions and implant placements can be considered and this should be explained to you at the time of consultation with your specialist plastic surgeon. This is a day surgery under general anesthesia.
3. Breast Augmentation in patients with Droopy Breasts

In our older patients who have more droopy breasts from breast feeding, we can use an implant with a larger volume and greater vertical height to give a breast lift effect with less scarring. However, if the breast droopiness is significant, then we would have to do a breast lift or breast reduction surgery. A good way to check this is to stand in front of the mirror with your arms by your side. Your nipples should be at the level of the midpoint between your shoulder tip and your elbow joint. If it is 2 cm lower, a simple augmentation may give you the lift you want. If it is more, then a breast lift or breast reduction surgery will be needed. This will be the topic of a future article.
As you can see, this topic is complex and a consultation with your specialist plastic surgeon is recommended.

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