Breast Augmentation with Implants or Fat Transfer: Which is Right for You?

by Markmann, Daniel

Breast augmentation is a procedure that increases the size of the breasts using either breast implants or transferred fat. The wide range of implants and approaches may seem complicated for patients who are considering the procedure for the first time. This comprehensive guide is intended to help patients learn more about their options for breast augmentation, empowering them to make more informed decisions regarding their procedure.

Dr. Daniel Markmann is a board-certified plastic surgeon and the medical director of Metamorphosis Plastic Surgery. Known for his safe techniques, exceptional bedside manner, and attention to detail, he has helped thousands of patients achieve their desired results.

To schedule your personal consultation with Dr. Markmann, please contact us online. To speak to a member of our team or schedule a consultation over the phone, please call (410) 465-3600.

About Breast Augmentation

Breast augmentation is a surgical procedure that can enhance the shape, size, and symmetry of the breasts. Breast augmentation has been one of the most popular and widely performed cosmetic procedures in the country since 2006, and was the second most popular cosmetic surgical procedure overall in 2023. ⁽¹⁾ Dr. Markmann can perform a breast augmentation using either breast implants or a fat transfer. Each approach offers unique advantages and stunning results, but the most effective approach for you will depend on your unique situation.

Breast Implants

When choosing an implant-based breast augmentation, patients will have the option of choosing the type of implants they would like to receive. Breast implants come in a variety of materials, sizes, and shapes.

Saline Implants

Saline implants are composed of a silicone shell with a sterile saline filling. Saline implants are placed empty and are inflated once placed within the chest, often requiring a smaller incision. Many women enjoy saline implants because of their low maintenance after placement, and any leaks or ruptures are quickly noticeable. ⁽²⁾ However, leaner patients or those with thinner breast tissue may find that this option is more prone to visible rippling.

Silicone Implants

Silicone implants consist of a silicone shell filled with a cohesive silicone gel to enhance the appearance and projection of the breasts. These implants are designed to mimic the natural softness of breast tissue. ⁽³⁾ These implants are highly popular and are less likely to cause visible rippling. Dr Markmann has all of his breast implant patients come in every year for a free annual implant check-up.

Shapes

Implants can come in a teardrop-shaped or round form. Round implants distribute volume throughout the breast more evenly, allowing for a fuller and more projected appearance. Teardrop-shaped implants are designed to replicate the natural shape and appearance of breasts, creating a fuller appearance at the lower pole of the breast.

Fat Transfer

A fat transfer breast augmentation is an alternative option to breast implants. However, the achievable size increase is much smaller with a fat transfer—patients often cannot achieve more than a one cup size increase. To perform a fat transfer, Dr. Markmann first uses liposuction to harvest fat from other areas of the body, such as the thighs, flanks, or abdomen, leaving them slimmer and more toned. The fat is then processed and purified to separate the healthy and viable fat before it is reinjected into the breasts. This variation of augmentation is ideal for those who do not want to have synthetic implants and want a more natural solution to increasing breast volume.

Suitable Candidates

Candidates for breast augmentation often include women who want to enhance the shape, fullness, and symmetry of their breasts. All candidates interested in this procedure should be in good overall health and free from any underlying medical conditions that may impair healing. Additionally, patients should have realistic expectations regarding the outcome of their procedure. Dr. Markmann will determine each patient’s candidacy for either fat transfer augmentation or breast implants during their personal consultation.

Personal Consultation

During a personal consultation with Dr. Markmann, he will explain each step of the procedure and converse openly with each patient about their medical history, medications, concerns, and ideal aesthetic. This will be followed by an evaluation of the breasts. Using this information, he will determine each patient’s candidacy and recommend the best methods to achieve their desired results.

To schedule your personal consultation at our office in Ellicott City, please contact us online. To speak to a member of our team or schedule a consultation over the phone, please call (410) 465-3600.

We also offer virtual consultations for international or out-of-state patients.

Preparation

Each patient will receive a set of pre-operative guidelines from Dr. Markmann, instructing them on how to prepare for their breast augmentation. Instructions may vary between patients depending on the surgical strategies being implemented, but each should be followed for a smooth recovery and ideal results.

Patients may need to undergo lab testing, imaging, or bloodwork beforehand to ensure they are physically healthy for their procedure. Medications and supplements containing blood-thinning properties should be temporarily discontinued, as they can interfere with the body’s natural healing abilities. Drinking alcohol should be avoided for several weeks before and after the procedure, as well as nicotine and tobacco use.

Because each patient will receive general anesthesia, it is important that transportation is arranged for after the procedure, and time off from work is taken to focus on healing. Any prescriptions or medications should also be filled ahead of time.

Procedure

While both variations of breast augmentation produce stunning results, the procedures themselves differ greatly. Each patient’s augmentation method will be predetermined during their personal consultation and selected according to their concerns, anatomy, and desired results.

Breast Implant Procedure

Dr. Markmann will begin the procedure by creating one of the following incisions:

Periareolar Incision: Along the outside perimeter of the areola.
Inframammary Incision: Beneath the breast crease.
Axillary Incision: Near the armpit.

Once the incision has been made, he will create a pocket to place the implant in. The implants can either be placed above or below the pectoral muscle, known as subglandular placement and submuscular placement, respectively; or they can be placed dual-plane, which is a combination of both. ⁽³⁾

Fat Grafting Procedure

Dr. Markmann will begin the fat grafting augmentation by performing liposuction to collect fat cells. Small, discreet incisions will be placed in areas where excess fat will be removed. A tumescent solution containing saline, epinephrine, and lidocaine will be injected into the fatty tissue to help minimize bleeding and swell the fat cells, making them easier to remove. Dr. Markmann will then use a cannula to gently remove the fat cells using suction. ⁽⁴⁾ Common areas for harvesting include the flanks, thighs, or abdomen.

These fat cells are then processed and purified to ensure only the healthiest, most viable cells are being reintroduced into the body. The purified fat will be carefully injected into the breasts, creating a fuller, more shapely appearance. Not all of the injected fat will survive through recovery, so Dr. Markmann may strategically inject an excess amount of fat into the breasts to compensate for this.

Can I Choose Both?

Many patients opt for a combined procedure using both implants and fat grafting to create more cohesive and transformative results. While some patients find the best results with the exclusive use of either implants or fat transfer, combining both can create a more natural-looking appearance, reducing the risk of visible rippling. Patients interested in combining both breast augmentation methods are encouraged to discuss this option with Dr. Markmann during their consultation.

To learn more about our other available procedures, please read Dr. Markmann’s blog!

Cost of Breast Augmentation in Baltimore, Maryland

The cost of breast augmentation can vary depending on several factors, such as the surgical methods used and patient goals. Dr. Markmann will discuss the cost of each patient’s procedure with them during their consultation. At Metamorphosis, we accept several different payment methods and offer various financing options through several reputable companies.

Schedule your consultation today to explore your breast augmentation options. If you have any further questions, please call our office at (410) 465-3600.

FAQ

How long will my breast implants last?

Breast implants can last up to 10-20 years before they need to be removed or exchanged.

Will I be able to breastfeed after undergoing breast augmentation?

Most women can successfully breastfeed after their augmentation. If this is a concern, we advise you to discuss these issues with Dr. Markmann during your consultation.

Are there any age restrictions to receiving a breast augmentation?

Breast augmentation with saline implants is approved for patients over the age of 18; silicone implants are approved for patients 22 or older. ⁽³⁾ Patients should be at least 18 years old for a fat transfer breast augmentation as well.

How visible will scarring be after my breast augmentation?

Scarring will depend on the type of augmentation performed and the specific incision placements used, but Dr. Markmann uses specific techniques to help minimize their visibility, keeping them discreet whenever possible.

Can both breast augmentation variations be combined with other procedures?

Yes, both implant-based augmentation and fat grafting augmentation can be combined with other procedures for more comprehensive results. For more information, we recommend discussing this option during your consultation.

References

ASPS. American Society of Plastic Surgeons ® Endorsed Partner.; 2023. https://www.plasticsurgery.org/documents/news/statistics/2023/plastic-surgery-statistics-report-2023.pdf
Patel BC, Wong CS, Wright T, Schaffner AD. Breast Implants. PubMed. Published 2021. https://www.ncbi.nlm.nih.gov/books/NBK441998/
Fardo D, Sequeira Campos M, Pensler JM. Breast Augmentation. PubMed. Published 2021. https://www.ncbi.nlm.nih.gov/books/NBK482206/
Li FC, Chen B, Cheng L. Breast Augmentation With Autologous Fat Injection. Annals of Plastic Surgery. 2014;73(Supplement 1):S37-S42. doi:https://doi.org/10.1097/sap.0000000000000271

Eli

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Jan S.

"I have had a very pleasant experience with Dr. Markmann and his staff, and I am very pleased with my results. He continues to see me in my follow up appointments, and I enjoy going to every one. His staff knows me by name and are very welcoming. I definitely recommend!"

Sara L.

"Dr. Markmann was very friendly, pleasant and very confident. All of his stuffs made me feel so comfortable from the day I walked in for my consult, through my surgery and my post-ops. I was very very nervous about having a breast implants done, but I couldn’t be happier."

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