While both procedures are performed to enhance breast appearance, natural breast augmentation differs from breast implants. One significant difference is natural breast augmentation, or fat transfer breast augmentation, offers patients the ability to have two procedures in one — liposuction to harvest fat cells from areas of unwanted fat, such as the abdomen, waist, hips, or thighs, and transfer of some of those harvested fat cells to the breast. Another significant difference is the advantage natural augmentation offers by utilizing the patient’s own fat cells, which is virtually risk-free in terms of allergic reactions and many other possible complications associated with breast implants, such as hardness, rippling, or a negative immune response. Several other differences are detailed below.
Breast implants involve inserting an implant, made from a variety of different materials and available in various sizes, directly into the breast, allowing patients the ability to see their final result immediately. Most breast implants are made from a rubbery silicone shell that is filled with either saline or silicone gel to make the implant. It is not uncommon for breast implants to be replaced after 10 – 25 years, depending on the type of implant. Natural breast augmentation offers permanent results; however, the results can be less predictable because it can take several weeks before it is known how many fat cells have successfully grafted to the breast tissue.
Patients looking for a more modest increase in breast size (1/2 to 1 cup) may be happier with natural breast augmentation because the results will look more natural and the breasts maintain a soft supple feeling. Saline or silicone breast implants can develop rippling and/or wrinkling resulting in an unnatural appearance and often feel hard. However, implants offer women the ability to predictably increase their breast size dramatically by several cup sizes. Fat transferred to the breasts feels natural because it is natural. The tissue under the skin of a breast is mostly fat.
Fat transfer breast augmentation has comparable cost to breast implants. Range is 5,000 to 15,000 dollars in the St Louis area. It is important to remember that natural breast augmentation involves two procedures – liposuction and fat transfer. This procedure takes considerably more time than breast implants because there is a significant amount of body sculpting involved in the areas where liposuction is performed and the process of injecting the fat cells into the breast is also a lengthy procedure. Natural breast augmentation also provides some savings as saline or silicone implants are unneeded and thus do not need be purchased; however, because of the liposuction procedure cost, the total cost is about the same. Because these are cosmetic procedures, health insurance generally does not cover fat transfer breast augmentation. Health insurance may cover breast reconstruction after mastectomy for breast cancer treatment.
The natural breast augmentation procedure involves injecting fat into the breast tissue using a very small cannula. The cannula creates a very small puncture into the breast tissue that virtually disappears after the healing process is complete. Patients considering breast implants must decide where and what type of incision they will have based on the type of implant that is chosen and how the surgeon performs the procedure. The incision is typically made either in the bellybutton area, under the arm, under the breast, or around the areola (nipple). The scar can be quite significant, especially if silicone implants are chosen.
Patients recovering from fat transfer breast augmentation are essentially recovering from two procedures and will experience swelling, bruising, and discomfort in their breasts and in the area(s) where liposuction was performed. Patients will also experience drainage in the liposuction areas. A sports bra is required for 2 – 3 weeks following the fat transfer procedure and a compression garment must be worn 24/7 for at least two weeks following the liposuction procedure. Because both the liposuction and fat transfer procedure are performed using local anesthetic, complications and recovery from general anesthetic is not a concern.
The breast implant procedure is more invasive than natural breast augmentation and usually done with general anesthesia. Patients must recover from a larger incision and possible trauma of the implant below the pectoral muscle.
Cosmetic breast augmentation is not associated with an increased risk for breast cancer. While it is not a scientifically settled matter, there is a potential concern that both implant and fat transfer breast augmentation procedures may affect breast cancer screening. Specifically, fat transfer for breast augmentation can cause calcifications that are seen on mammograms, which may make it more difficult to detect breast cancer. Breast implants may also possibly obscure the breast tissue, making the detection of breast cancer by mammogram more difficult. There have also been a very small number of reports of suspected implant ruptures during mammogram.
Breast implants also carry a risk of producing hardening around the implant due to the body’s response to exposure to a foreign substance. Further, silicone implants can rupture and slowly leak into the tissue surrounding the breast implant. There are still debates about the health implications of silicone leaking into the breast tissue. These adverse effects usually require removal of the implant. Women who have silicone breast implants are strongly recommended to have an MRI of the breast at least once every three years to check to see if the implants are intact.
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