Is fat transfer the new breast implant? Here’s what you need to know about the ‘natural boob job’

Instead, Dr. Killeen injects fat to add small, subtle amounts of volume in the breast to “camouflage some minor contour issues and even hide edges of implants that may have become visible after breast cancer, surgery, or in women who are just very thin and their implant is quite visible.”

Injections to the breast are often placed in “the upper part and middle part,” according to Dr. Nazarian, or just underneath the areola. “Those are the typical areas because usually the fat of the breast tissue kind of settles to the bottom,” she says.

In Dr. Subbio’s practice, fat injections to the breast are often performed in conjunction with a breast lift, reduction, or a breast augmentation with implants.

A fat-transfer breast isn’t going to look like a breast with implants

A big limitation with fat transfer to the breast, Dr. Subbio says, is that most women have a certain look in their mind. “They’ve become accustomed to what a traditional implant-based augmentation looks like — a round, physical, 3D structure,” he explains, adding that a physical implant shapes the breast to its form in a way that fat simply can’t. Dr. Stubbio continues: “It is not going to anywhere near as powerfully reshape the breast in the way that an implant can, and if a patient desires that look, she’s going to be sorely, sorely disappointed.”

Ideal candidates for fat-transfer augmentation have conservative goals

Dr. Nazarian’s fat-transfer patients typically love and want to keep their smaller breasts, but “they’ve lost some volume at the top or definition of their cleavage,” she says, adding that they don’t want an implant look. “They’re looking for just a little boost — a little more lifted look, a little bit more volume in the cleavage area.”

Often, Dr. Nazarian’s patients opting for a breast lift will also tack on a fat transfer to plump and round out any deflation at the top of the breast. “Adding a little bit of fat after the lift makes their breasts look more youthful,” she says.

Over-injecting is the biggest risk of a fat transfer

With any kind of injection, whether filler or fat, the biggest precursor to a complication is almost always over-injecting. “If you’re trying to stuff too much fat into a recipient in one sitting, it overwhelms their body’s ability to take that graft,” cautions Dr. Subbio. “And what happens is that fat can then become oil cysts — little sacks of oil fluid — or become calcified.” Those lumps can end up not only palpable but visible, and can be confused for tumours during mammograms, says Subbio, resulting in “unnecessary biopsies or anxiety over potential cancer.”

While some over-injecting is necessary, as some of the transferred fat will die off within four to six weeks post-op, Dr. Subbio’s rule of thumb is to only increase by one cup size per fat transfer procedure. Otherwise, he says, you’re wading into dangerous waters, especially if you’re small-chested to begin with.

Patients of both Dr. Nazarian and Dr. Killeen can expect an over-injection by about 20 percent, with the understanding that only 70 percent will stay. “The breast gets smaller than it was on the table because not all of it takes,” Dr. Nazarian says. “If you’re placing the appropriate amount of fat that you know that surface area can support safely, then you lower that risk significantly.”

Don’t fall for slick Instagram before-and-afters

Ah, Instagram — the ultimate source of smoke and mirrors. Even though most of us know perfectly well that the before-and-after photos or videos can be doctored (pun intended), that doesn’t mean they’re not convincing.