How can I get a breast augmentation without implants? Or “When fat is your friend.”

Fat Transfer from Butt to Breasts

I used to get asked this question all the time–meant as a joke. But the truth is, making your breasts bigger with your own fat can be a reality.

Fat injection is not a “new” procedure, and breast enlargement with autologous (your own, and no, you can’t use someone else’s) fat has been around for decades with good results, especially in Europe and Asia. I first heard about it a couple of years ago, at the Atlanta Breast Surgery Symposium. A plastic surgeon performed the procedure at a nearby hospital with satellite surveillance for the meeting attendees. It was the first time all day that I actually started paying close attention, as it was the first “new” thing in breast surgery that I’d heard anyone talk about yet. I was blown away—basically, the patient was getting the fat sucked out of her “problem areas” and injected back into her breasts! A dream come true!

The procedure just seemed like a natural addition to my liposuction practice. I researched it as much as possible—even spent two days in the operating room with Dr. Roger Khouri (one of the pioneers of the procedure in this country, as well as the creator of the BRAVA device) of Miami.

The first few I did on my friends, because what are friends for, right…? 🙂

Honestly, so far everyone has been thrilled. It’s truly an amazing procedure. I wish I could show before and after pics, but this is a G-rated blog.

So…What are the advantages over traditional breast implants?

1)     Easier recovery

2)     A two-for-one procedure

3)     Virtually scarless—the fat is injected with micro-cannulas, and even in darker skinned women the incisions usually completely disappear.

4)     Easier to shape, sculpt and lift the breast

5)     No risk of capsular contracture, rippling, or other implant “complications.”

And the biggest advantage is of course…if you gain weight, it will go straight to your breasts, because that’s where all those resistant, angry fat cells are sitting, just waiting to get bigger. (Anyway, that’s what I like to think, and it makes sense, and that’s what’s been happening.) So, worst case scenario–even if only a very small fraction of the fat stayed, just the fact that you will automatically gain weight in your breasts is a huge bonus—at the very least, as one of my patients said the other day, “It’s like a time-release breast aug!”

So what are the disadvantages?

 1)     You cannot guarantee the volume of fat that will stay—usually about 50—70% of what you put in.

2)     The most you can probably increase with one procedure is about half a cup size to maybe a cup size, so if you want to go from an “A” to a “C,” this is not the procedure for you.

3)     There are reports of interference with mammogram readings, however I have several patients who have had their one-year post-op mammogram and they are totally clear. I send all of my patients to my favorite radiologists in town, Lebovic, Schwimer and Goldberg, and they are very supportive of the procedure.

4)     The BRAVA device (optionally worn before and after the procedure) does improve results, but it’s not practical unless you are at home during the day, because it looks like an enormous Madonna Bra and you can’t wear it out of the house.

So who is the best candidate for autologous breast augmentation?

 Assuming you have the fat to spare…

1)     If you’ve always wanted your breasts a little bit bigger but never wanted implants…

2)     If you’ve had children and feel like your breasts have deflated and you just want to fill them back up again…

3)     If you don’t necessarily want to be much bigger but you want to be “fuller” …

…then this could be the procedure for you. And if you’re already scheduled for a lipo, ask your doctor about it. No reason to throw that good fat away! I would totally get it done tomorrow if I hadn’t already had all the fat sucked out of my thighs ten years ago when I was a resident at UCSD by my wonderful mentor, Dr. Anne Wallace. 🙂

This is one of my favorite subjects and I welcome any questions!!!!

LQ

***PHOTO ADDENDUM!***

I have had a lot of requests for Brava Before and After Pictures, so I found some G-rated ones for you 🙂 :

An "A" cup before Fat Transfer with Brava

A small "C" cup six months after fat transfer with Brava

35 comments
  1. Susan Morin said:

    Dear L.Q,I had an augmentation and I’m really happy….Would this have been a safer option?I’m pretty high risk.p.s…..I’ve met your mentor!

    • Susan you don’t have enough fat! 🙂 xoxo

  2. Emily said:

    I am so excited to see a more recent post on this. My question is…

    Could the procedure be done more than once?

    • Hi Emily,
      Yes, it can if the fat stores are there :). Sorry I have been crazy busy with work and the book and haven’t posted in forever, but sometimes I put little things up on the facebook stream so if you “like” Lipo Queen on facebook you won’t miss the little pearls of info.
      So far, all of the patients have been doing really well with the autologous fat transfer for cosmetic breast augmentation. I have some great pics. Now that I think about it I have been too busy to take pics in bras, but I will see if I can get some more up. You are also always welcome to come into the office for a consult where I can show you the “naked” ones, and I have a lot more pictures. My website is Drtrott.com. I still don’t have pics up there on it either but will have them soon.
      Thanks for writing!
      XO
      LQ

  3. wendy said:

    How much does this procedure cost?

    • Hi Wendy,
      The price varies of course, and I can only speak for my own practice. It generally starts at around $11 G and upwards. This includes OR (fully accredited facility), anesthesia (board-certified anesthesiologist), everything, and is comparable to the cost of a breast augmentation with silicone implants here in Beverly Hills where I practice. It also depends on the patient’s body type. If she is fairly thin and I have to go to multiple sites to harvest enough fat, it can take longer and the price can go up. Also, if the patient wants a “full body contouring” so that I’m actually liposuctioning “extra” fat that will not be used for the transfer, that is an additional procedure and more time/money. I hope that is helpful and makes sense. 🙂 I really do think it is a fantastic procedure though–from what I’ve seen in my own practice over the past several years. The redistribution of fat to an area where you actually want it so that when you gain weight it just goes there is worth every penny, I think. And like I tell everyone, if I hadn’t had my own fat sucked out ten years ago I would totally do it. Actually, I do have fat to spare but honestly, I don’t trust anyone else but myself to do this and–sadly–I can’t do it to myself. 🙂
      XO
      LQ

      • Sophia said:

        Thanks for all the great info. just wondering
        what you think of Dr khouri. does he respect the donor sites?

      • Hi Sophia,
        Glad you are finding the blog helpful. I know that Dr. Khouri gets great results with the fat injection. I have not seen any pictures or heard anything about what his donor sites look like. If you are considering seeing him, I suggest you ask to see photographs of the donor sites at the consultation. I have had patients tell me at consultations that I am the only surgeon who has pictures on the website of not only the breasts, but of the donor sites. I think this is just because I am a woman who cares about her body, and I understand that the outcome at the donor sites is as–if not more–important.
        Hope this is helpful!
        XO
        LQ

      • Sophia said:

        Thanks for the suggestion, LQ. I remember reading that u sometimes do phone consults w/ out of town clients & have them email photos to u. I was really impressed with the lipo photos on ur site but I live in nyc & it’s a bit diff. to fly to cali just for a consult. is there anyway I could email u photos?

        Thanks

      • Yes you can set this up with my patient coordinator, Nadia. You can email her through the website at silhouettecosmeticcenter@yahoo.com and she can set it up.
        I look forward to speaking with you!
        LQ

  4. Lorrie Okeniczak said:

    How much does something like putting fat from one place to another? Want fat taken from other places to my breast.

    • Hi Lorrie,
      Usually the price starts somewhere around $10G and up, including OR and anesthesia. It depends on how many areas you want to have contoured, or whether you want to just have enough fat removed to transfer. I would be happy to see you in consultation, either in my office or by Skype or phone if you live far from L.A.
      XO
      LQ

  5. A said:

    I’m interested in knowing where I’ll be putting weight on, post breast-augmentation using body fat from my thighs and abdomen?

    • Well, hopefully you won’t be putting too much weight on after the procedure because you would be motivated to stay in shape. But it would definitely redistribute your fat to some extent so that you would be more likely to gain in your breasts and less in the areas that were suctioned. But I would have to see you in consultation and evaluate you to give you more specific advice than that. It really depends on how much fat is removed, transferred, and how well it takes.
      Hope that is helpful!
      XO
      LQ

  6. Cat said:

    This is so interesting because I dislike my “deflated” B-cup breasts but would not want a foreign substance inside me like an inplant. How much fat would you need to have elsewhere for this redistribution to work? I am in decent shape and have a little bit on my buttocks and belly area but (thankfully) it’s not enough that I have ever considered liposuction or even dieting, my shape is fine. So… is that blessing a curse in this instance? And also I was thinking of having mine lifted since they’re kind of saggy – is that possible with this procedure also? Or not recommended? Thanks so much – I have found this blog very informative and I appreciate your blunt commentary, there is no point in pussy-footing around like some sites do.

    • Hi Cat,
      Glad you are finding the blog helpful! If your nipples are not pointing downward, it is likely that you can get a lift from autologous fat injection as well. However, it’s very difficult for me to quantify exactly how “much” is needed for this to be a successful procedure. I usually need at least a couple hundred cc’s of fat for each side (translation–a can of Coke is 356 cc, however I know that probably still doesn’t help you much.) I can almost definitely say that athletic women who are roughly 5’6″ and 110–115 pounds usually don’t have enough fat to take. I have a couple of thin women in the “breast augmentation without implants” section of the photo gallery on my website drtrott.com that may help give you an idea of what is possible. If you don’t have ANY areas that you can pinch that you would like to get rid of, then you are probably not a good candidate. However, there are very few of us that don’t have SOMETHING to redistribute :). Usually in very thin women it’s the lower back or “muffin top” area that is a good donor site because it usually crops up in our late thirties and forties no matter how much we work out. Regardless, the best way for me to tell is to see you in consultation. I do phone consultations but even with pictures it can be hard to tell.
      Hope this is helpful.
      XO
      LQ

  7. Sarah nicholson said:

    Is this procedure available in the U.K. And what’s the cost I have had a baby 3 months ago am 21 years old Andy boobs feel empty am not fussed about the size but would love to have the fullness back thank you for any help you can give

    • Hi Sarah!
      It sounds like you are a perfect candidate for the procedure, as long as you have the donor sites. I recommend waiting at least six months after you finish breastfeeding to do any breast procedure. Since I don’t personally know any plastic surgeons in the U.K., I did a Google search and did find some places in London that perform this procedure. Here’s one: http://www.theprivateclinic.co.uk/treatments/fat-transfer/breast-augmentation
      However, I cannot really recommend anyone because I don’t know their qualifications and I would not want to steer you in the wrong direction. At this time the only European plastic surgeon that I know personally that I could recommend is Dr. Christian Niehus at Clinic Utoquai in Zurich. http://clinic-utoquai.ch/de/team/aerzte/christian-niehus
      He specializes in body contouring and takes great care with the liposuction.
      Otherwise, if you want to stay in the U.K., I would do research and find a board-certified plastic surgeon who does a lot of liposculpture and ask to see pictures.
      And of course if you can travel to Beverly Hills, I would be happy to help you! 🙂
      The cost for the procedure when I do it usually starts at around $11,000 U.S, depending on how much liposculpture is involved.
      Good luck! If you would like more information from my office manager about cost, etc, her name is Nadia and she can be reached at (310)-275-3990 or Silhouettecosmeticcenter@yahoo.com

      XO
      LQ

  8. Crystal said:

    Hi I live in Townsville QLD,just wondering if you could tell me who in qld does breast implants and how much it will cost many thanks

    • Hi Crystal,
      Unfortunately I know nothing about plastic surgeons in Australia but I did find the link for the Australian Society of Plastic Surgeons: http://www.plasticsurgery.org.au
      This would be a great place to start because it looks like this society is analogous to our ASPS, which holds the highest standards for board-certified plastic surgeons in the U.S.
      You can put in your location–I entered Queensland and a bunch came up. I would check out their websites, look for before and after pictures, see if there is a certain doctor’s style that you like or dislike. As far as the price–here in Beverly Hills I would say the average for the entire procedure is about $10,000 U.S. dollars, but I don’t know how that translates to Australian currency. It could also be more or less here.
      Hope this is helpful. Good luck!
      XO
      LQ

  9. Cathy said:

    I’m 49 to be fifty in May……I used to be really skinny up until 46 and hormones really started kicking in…..I’ve mostly gained in my belly and I’m hating it since I’ve always had a flat tummy! It’s really bothering me.. I also have had smaller breast being thin and unfortunately the fat isn’t accumulating only in my breast…..I thought abt getting silicone or saline breast several yrs ago but my mother got them and she had hardening……so decided I’d rather not have a foreign substance in my body if I can have my fat actually used for some good…… My question to you is do I sound like a good candidate? Btw…I’m in perfect health!

  10. V said:

    Hello there Lipo Queen! So happy to come across your post.
    I am 25 with 2 little girls. I had my first one at 18 and the second child at 23 and now my breasts are completely gone! They were ok after I had my first child, but now that I’ve had my 2nd, my breasts have no fullness/fat and they are droopy and saggy. So sad to experience this at the age of 25! Although my partner doesn’t mind, I am just a tad bit insecure about the fact that they aren’t firm and perky. I actually don’t mind the size as I used to be a 34 C and am now about a 32B. The side of my boob doesn’t sit well as I’d like it to be and my cleavage is gone too. I hope I’ve painted a good example of how my breasts look because I’ve always wondered if I can get breast surgery without the silicone. I am a skinny girl and don’t have any fat to transfer to my breasts either (the only place i can think of is my stomach which is not too bad in looks either) but I am wondering if this would be a fit surgery for myself? Or if you know what would be best for me as far as looking for firmness in my breasts? is it necessary that I have surgery? I don’t think working my arms out would help my pectoral muscles and lifting my breasts (so they’ve told me). Thank u in advance for your response!

    • Hello! Sorry for the delayed response but this end-of-the-year time is so hectic! Hope you are enjoying the holidays.
      From what you have described, it sounds like you have lost breast volume with pregnancies, and your breasts now feel “empty.”
      Fat transfer to fill them back up really is a fantastic way to go if it is possible. It’s possible that even though you are very thin, you may have a couple of areas where the fat can be taken from. I have some very thin patients where I often get it from the lower back or “muffin top” area. However, if you really don’t have any fat to spare, it sounds like you would either need an implant (silicone or saline) and/or a lift. The lift can be done without an implant to tighten up the skin and make your breasts look younger and perkier, but you would probably need at least a “lollipop” or “anchor” scar.
      Unfortunately, working out your arms and building your pectoral muscles is not going to help firm up your breasts.
      Hope this is helpful. If you would like to have a formal consult where I can review pictures and talk to you on the phone (I’m assuming you don’t live in Los Angeles) please contact my office through my website at drtrott.com and we will take care of you.:)
      Hope this is helpful! Happy New Year!
      XO
      LQ

  11. Darling said:

    Very informative blog, LipoQueen. Reading through this article and the comments has helped to solidify my decision to get the AFT + BRAVA procedure. I understand that one of the concerns of the breast fat transfer procedure was the potential to give false positive readings on mammograms, although I’ve also read that doctors can detect the difference between cancerous sites or benign calcification from the fat transfer procedure in the breasts. Which is true? Also, what sort of precautions do you take or recommend before and after the procedure in regards to this? I’m 25 with no history of breast cancer in my family, would you recommend that I get a mammogram before the procedure to get a baseline reading of the breasts?

    • Hello and thanks for reading! Glad you’re finding this blog informative.

      Here’s my answer:

      Initially (about four years ago) one of the many arguments against AFT was that it would interfere with mammograms, giving false positive readings.

      What you need to understand is this: except for those of us who already had large liposuction practices, the overall knee-jerk reaction of most plastic surgeons was to come up with reasons not to do it. Why? It’s time-consuming and therefore not economically efficient for the average plastic surgeon. This is understandable. I mean, if I had three ex-wives and four kids to put through private school in Los Angeles I too would come up with a million reasons not to do it, and continue to just offer breast implants for augmentation because they take a fraction of the time. Also, there is no “disposable” that is going to make an implant company (and the plastic surgeons who get paid to speak for them and do clinical trials) a lot of money.

      As of now, the consensus in our scientific literature is basically that “If your radiologist can’t tell the difference between the microcalcifications of malignancy versus fat transfer, they shouldn’t be reading your mammogram.” I work with a group of radiologists in Beverly Hills who are very comfortable with the mammograms of the fat transfer patients.

      In addition, there are many papers out right now about mammograms and fat transfer.

      http://journals.lww.com/plasreconsurg/Fulltext/2012/01000/Clinical_Analyses_of_Clustered_Microcalcifications.68.aspx

      http://journals.lww.com/plasreconsurg/Fulltext/2011/03000/Radiographic_Findings_after_Breast_Augmentation_by.32.aspx

      http://journals.lww.com/plasreconsurg/Fulltext/2012/05000/Mammographic_Changes_after_Fat_Transfer_to_the.1.aspx

      These links should bring you to the abstracts (summaries) of the articles, where you can just jump down to the “conclusions” section.

      If the links above don’t work, Google our journal Plastic and Reconstructive Surgery and put “fat transfer and mammograms” into the search

      My personal recommendation is just to have a baseline mammogram and ultrasound beforehand (MRI if you can afford it, because insurance probably won’t pay) and go to a center where there is a radiologist who is comfortable with these mammograms for your follow ups.

      Hope this is helpful!
      Good luck!

      XO
      LQ

  12. Victoria said:

    Hi, I’ve always have had an embarrassing problem when it came to my breasts, one is much bigger than the other for some reason, like the right one never fully developed, so I always look lopsided and it can be a bit noticeable through clothes. I was wondering if something like this could be done for my specific problem? I do have some slightly fatty areas that might be right for the job. Also, I live in southwestern Michigan (border of Indiana), might you know of some places around here that may do that kind of work?

    • Hi Victoria,
      It sounds like you probably have a tuberous breast. Have you googled that at all to see if the pictures look similar? Regardless, fat transfer could be a good procedure to help even out your breasts if you do not want an implant. I have done this for several patients, sometimes with a lift on the larger side if that side is much saggier. For optimal results, you may want to consider doing it more than once, because each time the fat does seem to take better, and you would likely get closer to your goal of matching the other side. It would probably be difficult to do in one procedure because the skin on the smaller side is so much tighter, and the fat takes better when the skin is looser. Also, if possible you may want to consider using the BRAVA device (see my post on BRAVA expansion), as it can help the take of the fat.
      Unfortunately I do not know anyone in your geographic location. The best way to start your research would be by finding a board-certified plastic surgeon through the ASPS website http://www.plasticsurgery.org and then consult with a few who perform this procedure.
      Hope this was helpful! If you aren’t having any luck and you would like to set up a phone consultation through my office I could further answer your questions. My patient coordinator Nadia can be reached at 3102753990, and her email is silhouettecosmeticcenter@yahoo.com
      Good luck!
      XO
      LQ

  13. amy said:

    hi I am 31, I had breast implants 5 years ago due to two lots of breast feeding from a 34c/d to a 32 a, this potion was not passed onto me or I would of took it, I am now a 32f could I have them taken out and filled with fat? I have some areas with a bit extra many thanks

    • Hi Amy,
      Removing implants and replacing with your own fat is becoming an increasingly popular option. You are probably a good candidate for this, however for me to further determine this I would have to discuss it in consultation–over the phone if you do not live in the LA area.
      If you would like to talk further, please contact my office 3102753990 and my staff will set up an appointment for you. I hope we get to talk soon! If not, I would recommend that you research your geographic area for a board-certified plastic surgeon who is familiar with this procedure. You can start your search with the American Society of Plastic Surgeons website.http://www.plasticsurgery.org
      XO
      LQ

  14. yesenia said:

    Hi my name is yesenia , So ive been reading about so much about transferring fat and making your boobs bigger , I have this problem with trying on bathing suits and one boob always fits perfectly and the other one is always extremely bigger I would say the right is a C-D cup and the left has to be more than a D its always hurting myback I was wondering would it be a good idea to take some fat out from my left one and add it somewhere else ir what should I do its so uncomfortable having one bigger than the other and its noticeable with a bathing suit on.

    • Hi Yesenia,
      Thanks for reading. Usually we do not take fat from one breast and put it in the other–usually we use a separate donor site, like muffin top, thighs, tummy, etc.
      XO
      LQ

  15. Mari said:

    How do I get in touch with the doctor that posted this info. I would like a consultation with this doctor. Thank you

    • Hi Mari!
      Glad you found it helpful! Check out Dr. Suzanne Trott at Drtrott.com
      XO
      LQ

  16. Angie said:

    I have small frame and 800c implants so with working out I’ve lost weight since my op .. I’ve some rippling but not overly yet . When I am not flexed I have pipping on top and definitely when I bend over . I’d like to know , would fat transfer would cover it ? I’ve heard of it as option before .

    Angie

    • Hi Angie,
      Fat transfer is often used to cover rippling. Of course I would have to see you in consultation to determine if you are a candidate. My “go-to” area for harvesting is the “muffin top” area. Even if you are small, most people have something that can be removed there.
      Good luck!
      XO
      LQ

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