Two ways to increase breast volume
Breast augmentation can be done in two ways: with implants, or with the patient's own fat, a technique called breast fat transfer (breast lipofilling). Both are cosmetic surgery procedures performed in the operating theatre by a plastic surgeon.
They address similar but not identical concerns: breasts felt to be too small, breasts that have lost volume after pregnancy, breastfeeding or weight loss, a difference in size between the two breasts, or a malformation such as tuberous breasts.
The key difference lies in the volume that can be achieved and how it is obtained. This article helps you understand both options so you can discuss them calmly in consultation; it does not replace the advice of the surgeon, who alone can examine you and advise you.
Breast implants: a volume gain chosen in advance
Augmentation with implants involves placing an implant behind each breast. The surgeon and the patient choose its shape (round or anatomical), volume and projection together, as well as its position, in front of or behind the pectoral muscle. Sizing trials during consultations help you picture the result.
The procedure is performed under general anaesthesia and usually lasts 1 hour to 1 hour 30 minutes. The incision is short, most often placed in the fold under the breast. The hospital stay is short, and a support bra is worn for a few weeks.
The result is visible immediately, then becomes more natural over the following weeks as swelling subsides and the implants settle. Implants allow a clearer volume gain than fat, which is predictable since it is decided before surgery. On the other hand, they require regular monitoring over time.
Breast fat transfer: moderate volume, without an implant
Breast fat transfer uses the patient's own fat. It is harvested by gentle liposuction from a reserve area (abdomen, hips or thighs), prepared, then re-injected into the breasts in fine tunnels at different depths.
The procedure is most often performed under general anaesthesia and takes about 1 hour 30 minutes to 2 hours 30 minutes. Patients go home the same day or the next day. The breasts are swollen at first and the harvest areas are tender, as after liposuction; a compression garment is worn for a few weeks.
The volume gain is limited and variable: part of the injected fat is reabsorbed, and two sessions are sometimes needed. The final volume can be assessed after three to six months. In return, there is no foreign body, and the harvest area is slimmed.
What guides the choice in consultation
There is no single right answer for everyone: the choice is made with the plastic surgeon, after examining the breasts and the possible harvest areas. Several factors matter:
- the volume you want: a clear increase points towards implants, a subtle increase can be achieved with fat transfer;
- your fat reserves: fat transfer requires enough fat to harvest, which is not the case for every slim patient;
- whether or not you want an implant, and accept the monitoring that comes with it;
- the shape and quality of the breasts: asymmetry, tuberous breasts, deflated or sagging breasts;
- your general health, your medical history and your plans (pregnancy, weight loss).
Combining techniques, or considering a breast lift
The two approaches are not always opposed. In a patient who already has implants, fat can for example hide a visible edge and soften the cleavage. Fat transfer is also used in reconstructive surgery, to correct a deformity after breast cancer treatment or to refine a breast reconstruction.
When the breasts are mainly sagging, adding volume is not always enough: a breast lift (mastopexy), sometimes combined with an implant, may be suggested. Conversely, breasts that are too heavy call for a breast reduction.
The surgeon explains the options suited to your situation, their advantages and limits, and gives you time to think before any decision.
Preparation, recovery and follow-up
Whatever the technique, preparation includes consultations with the plastic surgeon, an anaesthesia consultation and, depending on age and history, breast imaging (mammography and/or ultrasound). Stopping smoking is recommended to help healing. Precise instructions, especially about fasting and medication, are given to you by the team.
After surgery, a feeling of tightness or bruising is usual in the first days and is managed with the prescribed treatment. Sports activities resume gradually, as advised by the surgeon.
Like any surgery, these procedures carry risks, explained in consultation: capsular contracture around the implant or a temporary change in nipple sensation for implants; partial reabsorption of fat or small fat nodules, usually benign, for fat transfer. In both cases, always mention your surgery at future mammograms.
Frequently asked questions
Can fat transfer replace implants?
Not always. Fat transfer provides a moderate and variable volume gain, because part of the fat is reabsorbed. It mainly suits women who want a subtle increase and have enough fat reserves. For a clearer volume gain, the surgeon will usually suggest implants.
How long does the procedure take?
According to the clinic's procedure pages, augmentation with implants usually lasts 1 hour to 1 hour 30 minutes under general anaesthesia. Breast fat transfer takes about 1 hour 30 minutes to 2 hours 30 minutes, as it includes harvesting the fat and then re-injecting it.
When is the result final?
With implants, the result is visible immediately and becomes more natural over the following weeks. With fat transfer, the final volume can be assessed after three to six months, once the fat has settled; a second session is sometimes needed.
Can I have a mammogram after breast augmentation?
Yes. Breast imaging is in fact requested before surgery depending on age and history, and radiological follow-up remains possible afterwards. You simply need to tell the radiologist that you have implants or have had fat transfer.
How can I get a quote for breast augmentation?
You can request a quote online on the clinic's website. The project is then defined in consultation with the plastic surgeon, who chooses the suitable technique with you.
This article is for general information only. It does not replace the advice of your doctor, who alone can adapt instructions to your situation.
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