How can I get a breast augmentation without implants? Or “When fat is your friend.”
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
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
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,
. 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.
Yes, it can if the fat stores are there
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
How much does this procedure cost?
Hi Wendy,
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. 
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.
XO
LQ
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
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
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
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