No Implant Augmentation

Sounds almost impossible or true good to be true right?

Perhaps the better question is, can plastic surgeons imagine a universe where patients don’t need breast implants for improving breast shape and volume or are we stuck in a single dimension with implants that will likely need replacement or revision down the road after insertion or worse can cause serious complications or even health related consequences?

What I have found in my breast aesthetic practice is that most surgeons performing augmentation surgery with implants don’t take the time to inform or educate their patients regarding the long-term issues related to silicone breast implants. More and more, patients are coming to the practice to have their implant devices removed and I sense they just weren’t prepared for the consequences of implants.

What would be breast augmentation options and alternatives in a parallel happy Universe of open minded surgeons, giving patients true freedom of choice, where plastic surgeons could expand their horizons beyond the allure of the all powerful and ever present implant for breast augmentation?

First, let me say that in my practice I use breast implants every day to solve difficult reconstructive challenges and afford patients excellent results. But what I have learned is that implants are not for every patient for a variety of reasons. Through the lessons learned from the reconstructive side of my practice, I have honed in on a few alternatives to give patients improved shape, volume and an overall enhanced breast result free of implants.

So, the answer to the above question is a resounding and emphatic YES! There are a few options for non-implant based breast augmentation. Off the top of my head, I can come up with at least 3 alternatives to implants which would include the most common option of fat-grafting. Also known as lipofilling, breast augmentation with fat transfer is a natural process that uses your own fat to enhance breast size and contour. Liposuction is performed to collect fat from areas such as the abdomen, thighs, or flanks. This fat is then processed and refined and carefully injected into the breasts to augment breast volume and shape.

I like the option of fat grafting the breast because it uses your own tissue without introducing a foreign body and affords minimal down time without noticeable surgical scars. A clear disadvantage is a gradual loss of volume over time, on average 30% loss, and not all patients have enough donor site material to work with.

If I’m not a good candidate for fat grafting would I be forced back to implant augmentation? Not necessarily, there are 2 more options available, a surgical consideration using your own breast tissue to “auto-augment” the breast for better projection and shape and a non-surgical approach using fillers such as hyaluronic acid or biostimulators which are both used throughout the body for volume enhancement and rejuvenation.

The auto-augmentation approach follows similar principals and patterns that we commonly use for a breast lift, but instead of removing tissue, we use the breast tissue from the lower part of the breast to support the area under the nipple and areola for more projection and volume. The results can be quite impressive with this technique, but for some reason I find it often overlooked. The downsides are minimal because similar to fat grafting it relies on using your own tissue so no need for implant exchange down the road or issues related to implants. The potential for projection is also good but may not be as great as an implant. As with breast lifting procedures, incisions are needed to complete the pattern but are well tolerated aesthetically.

So what is this last non-surgical option we keep hearing about or for that matter haven’t heard about for breast augmentation? Who is a good candidate for it and where can we get this done?

I know the concept of no implant augmentation is almost too good to be true and you are wondering why isn’t my local corner plastic surgery office offering this?!

To start, I totally agree, non-surgical breast augmentation is such a fantastical concept it almost seems like a unicorn so to speak. I was first exposed to and understood the concept during my training in Paris for the masters in breast surgery project I undertook. I quickly understood that not only did the French have better food and bakeries, but that the Europeans were innovating faster than we were back home.

The French had mastered the art of fat grafting for breast reconstruction and augmentation but to further advance the idea and concepts around no-implant based surgery they were working with hyaluronic acid fillers for immediate non-surgical augmentation. They called it the “lunch time” augmentation and the outcomes were impressive.

At some point, the French stopped performing the procedure because there was uncertainty regarding the impact on routine screening for breast cancer. But I never understood the arguments against the procedure as long as you concentrated on placing the filler in the same location as you would a breast implant.

If you are interested in breast augmentation but do not require permanence of the result then non-surgical breast augmentation is a good option for you. It is ideal if you need an immediate result with no surgical recovery to slow you down. You may have a special occasion or event that you want to look you best breast self or just want to have a change and see what the potential of a permanent augmentation could give you.

I hope by now, you are willing to explore and consider the No Implant options for Breast Augmentation, whatever your goals are or the level of curiosity you have, there can be an alternative option for you!