Maria M. LoTempio, MD, is a double board-certified plastic surgeon specializing in reconstructive surgery and otolaryngology (head and neck) surgery.

Some women like the idea of having bigger breasts, but don't like the idea of breast implants. Breast augmentation with fat is technically known as autologous breast augmentation.

This procedure uses a woman's own fat instead of implants to increase the size of the breasts. The fat is liposuctioned from another body area.

This article explores the benefits and drawbacks of this type of breast augmentation.

In the past, the American Society of Plastic Surgeons (ASPS) did not recommend the use of fat to enlarge breasts. In 1987, the ASPS said the side effects could make it harder to screen for breast cancer. Side effects of autologous augmentation can include:

At that time, plastic surgeons stopped performing the procedure.

More recently, the ASPS Fat Graft Task Force has stated that the procedure may be useful in some cases.

The procedure is also called "stem cell breast augmentation." This label is misleading. Fat does contain stem cells. A stem cell can develop into different types of tissue based on where it is placed in the body. However, stem cells alone cannot be injected into the breast to increase breast size. They must be combined with fat.

Before you decide to have this procedure, it's important to understand the possible long-term effects of fat transfer to the breast.

Uses woman's own fat

Breasts look and feel natural

Patients and doctors are satisfied with the results

Only enlarges one cup size

Breast lift may still be needed

Calcifications may interfere with breast cancer imaging

Must have enough spare fat to transfer

Fat necrosis (small hard masses which look like cancer) may be permanent

During the procedure, fat is suctioned from another part of the body and injected into the breasts.

The benefit is that there is no need for an implant. If the fat heals well, the breasts look and feel normal. The only incisions are the 4-millimeter cuts used to remove and re-inject the fat.

If you have grade 1 ptosis (mildly sagging breasts), this procedure could be ideal for you. Looser skin creates a more open pocket for the fat. Tighter breasts may make it harder for fat tissue to survive.

When used to enlarge healthy breasts, the procedure has a good track record. It has fewer complications than implant surgery. And fewer people end up needing another operation later.

Case reviews have found that most women and their doctors are happy with the results. And for people who have had breast surgery to treat cancer, studies have found that autologous augmentation does not raise the risk of cancer coming back.

Still, there are some disadvantages to autologous breast augmentation. Surgeons have published detailed descriptions of how to remove and inject fat to increase breast size. But there is no standard technique for the procedure.

For this reason, you'll want to find a surgeon with a successful track record with this procedure. It is also important to know what the procedure can and cannot do.

Your breasts will only increase about one cup size. Here's why.

Before you have the procedure, your doctor will use a tissue expander to make a pocket for the fat and to increase blood flow to the area. Better blood flow is needed because fat does not have its own blood supply to keep it alive.

The tissue expander only supports a limited amount of fat. At most, an A-cup breast will increase to a B-cup. With breast implants, there is no such limitation.

This type of breast augmentation will not raise breasts that are sagging. A separate breast lift surgery would be needed to improve sagging.

Because fat does not have its own blood supply to keep it alive, it uses the blood supply already in the breast. That's why a limited amount of fat can be injected.

If too much fat is injected, it will be reabsorbed. That means the breast size can shrink again. It's also possible for the fat to harden.

Fat injection can make it harder to detect breast cancer. The added fat is prone to calcifications. These small, hard specks will be visible on a mammogram. They may be there for the rest of your life.

The pattern of those specks is different from the ones that happen with breast cancer. Still, they may mean you'll need more frequent breast biopsies, especially if you have a family history of breast cancer. You may need to monitor changes and have follow up screenings throughout your life.

It is best to have a mammogram before a fat-graft procedure. If you're under 30, you may also need an ultrasound. Those images will help your health care team spot new calcifications.

Not everyone has enough extra fat for this procedure. To effectively increase breast size, the surgeon needs to harvest at least 1,000 milliliters of pure fat.

Your surgeon may rely on you to do the external expansion before the procedure. People who are self-motivated tend to have better results, especially with the self-directed expansion.

Autologous breast augmentation is a procedure that enlarges breast size by injecting your own body fat into the breasts. The procedure usually works well and has few complications.

The procedure has several advantages. First, it uses your own body fat instead of an implant. It requires very small incisions, and the breasts usually look and feel natural.

There are some downsides to consider. One is that your breasts will only be about one cup size larger. Another is that you might still want a breast lift because injecting fat won't tighten loose breast skin. It's also possible for calcifications to form, which may complicate breast cancer screenings down the road.

Not everyone is a good candidate for this procedure. If you have very little body fat, you might want to discuss other options with your plastic surgeon.

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Groen J-W, Negenborn VL, Twisk JW, Ket JC, Mullender MG, Smit JM. Autologous fat grafting in cosmetic breast augmentation: A systematic review on radiological safety, complications, volume retention, and patient/surgeon satisfaction. Aesthetic Surgery Journal. 2016;36(9):993-1007. doi:10.1093/asj/sjw105.

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Vyas KS, DeCoster RC, Burns JC, et al. Autologous fat grafting does not increase risk of oncologic recurrence in the reconstructed breast. Ann Plast Surg. 2020;84(6S Suppl 5):S405-S410. doi: 10.1097/SAP.0000000000002285.

Agha RA, Fowler AJ, Herlin C, Goodacre TE, Orgill DP. Use of autologous fat grafting for breast reconstruction: A systematic review with meta-analysis of oncological outcomes. Journal of Plastic, Reconstructive & Aesthetic Surgery. 2015;68(2):143-161. doi:10.1016/j.bjps.2014.10.038

Largo RD, Tchang LA, Mele V, et al. Efficacy, safety and complications of autologous fat grafting to healthy breast tissue: A systematic review. Journal of Plastic, Reconstructive & Aesthetic Surgery. 2014;67(4):437-448. doi:10.1016/j.bjps.2013.11.011

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