Volume without an implantNon-implant breast augmentation matched to your body fat
Non-Implant Breast Augmentation (Fat Grafting · hADM · HA)
Non-implant breast augmentation adds volume with autologous fat, hADM or HA instead of an implant; the suitable method depends on how much enlargement is needed and how much body fat is available.
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Overview
Non-implant breast augmentation is the general term for methods that add volume without placing an implant. Autologous fat grafting, which transfers your own fat, is the mainstay; when there is not enough fat to harvest or only a specific area needs reinforcing, materials such as hADM (allogeneic dermis) and HA (hyaluronic acid) are considered. Rather than a large increase, it generally suits a natural change of about half a cup to one cup.
The enlargement you can obtain depends on how much fat can be harvested and how much give the breast skin has. Part of the grafted fat is absorbed, so at consultation we look at your body-fat distribution together with the volume you want and tell you in advance what is possible in one session and how many sessions may be needed. Separating what is possible from what is difficult from the outset is the heart of the consultation for this surgery.
Whether an implant is not right for you or you simply want a small difference without one, the Director consults with you and performs the surgery herself. If we judge that fat grafting alone is unlikely to give the volume you want, we also consider implant breast augmentation or a hybrid method that combines an implant with fat grafting.
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Recommended for
You do not want an artificial implant placed in your body
You want a natural enlargement of about half a cup to one cup
You have enough fat to harvest from the abdomen, thighs or elsewhere
You only want to fill hollowing in the upper breast or even out a volume difference between the sides
You want to soften the edge contour or rippling after implant breast augmentation
You would like the abdomen or thighs contoured at the same time through fat harvesting
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Surgery & treatment methods
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Autologous fat grafting
Fat is suctioned from the abdomen or thighs, purified, and injected in small amounts in several layers around the breast tissue and in the subcutaneous layer. Fat placed in a large amount in one spot does not receive blood supply and dies, so spreading it thinly is the key to survival. The donor area loses fat, giving a contouring effect as well; part of the grafted fat is absorbed and the rest remains.
Suited for · You have fat to harvest and want an enlargement of about half a cup to one cup
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hADM (allogeneic dermis) grafting
A material made by processing donated human dermis and removing its cells, used when fat is insufficient or the thickness of a specific area needs reinforcing. It is mainly used to cover the edge of an implant so its contour shows less, or to reinforce the tissue beneath thinned skin. It is not a material for creating large volume on its own.
Suited for · Not enough fat to harvest, or localized thickness reinforcement is needed
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HA (hyaluronic acid) injection
A method of adding volume by injecting a hyaluronic acid product. There is no incision, the treatment time is short and the burden of surgery is low, but it is absorbed over time so its duration is limited, and nodules or migration can occur. It can affect the reading of breast imaging, so you should tell the examiner about the treatment at screening.
Suited for · You want a small, temporary addition of volume without surgery
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Combining an implant with fat grafting (hybrid)
When fat grafting alone is unlikely to give the volume you want but you are concerned about the implant contour showing, an implant creates the volume and fat is grafted over the thin areas at the same time. Details are in the hybrid section of the implant breast augmentation page.
Suited for · You want an enlargement of one cup or more but have thin subcutaneous tissue
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Key facts
Surgery time
About 1.5–3 hours (varies with the extent of the donor area; HA injection about 30 minutes to 1 hour)
Anesthesia
Sedation or general anesthesia (local anesthesia for HA injection)
These may vary depending on your condition; we will give you precise details at your consultation.
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Atelier Plastic Surgery's approach
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We tell you plainly how much volume you can expect
Part of the grafted fat is absorbed, and the proportion varies by individual. At consultation we check how much fat can be harvested and how much give the breast skin has, and explain in advance the enlargement you can expect from one session and the likelihood that an additional graft will be needed. Narrowing the gap between expectation and result is where this surgery begins.
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We follow a process for fat survival, from harvest to injection
Fat is harvested at low pressure to reduce cell damage, separated from blood and oil, and injected in small amounts across several layers. Placing a large amount in one area lowers the survival rate and makes fat necrosis and cysts more likely, so we do not over-inject.
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The material is chosen by where it is needed
We think of overall volume as a job for fat, localized thickness reinforcement for hADM, and temporary, non-surgical supplementation for HA. We decide after explaining the duration, limits and effect on imaging of each material.
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When an implant suits you better, we say so
If you are slim or want an enlargement of one cup or more, fat grafting alone is unlikely to give the result you want. In that case we do not push ahead, and consider implant breast augmentation or a hybrid method instead.
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After surgery
Day of surgery
You are discharged the same day after recovering from anesthesia. You wear a compression garment over the donor area; the breasts are not compressed.
Days 1–3
There is bruising, swelling and stiffness at the donor area. Avoid pressing on the breasts or sleeping face down, and take the prescribed medication.
Week 1
Stitches at the donor area are removed. Seated work and short outings are mostly possible; bras that compress the breasts are still avoided.
Weeks 2–4
Bruising at the donor area fades and you continue wearing the compression garment. Light aerobic exercise can start depending on your condition; exercise that jars the breasts is avoided.
Months 1–3
As absorption of the grafted fat progresses, the volume gradually stabilizes. It is normal for the size at this stage to be smaller than it was at first.
Months 3–6
Fat survival is complete and the final volume is assessed. If needed, an additional graft is discussed at this point.
Recovery care and the aftercare schedule are described in the Safety Care System. Safety Care System
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Side effects · Precautions
Non-implant breast augmentation may cause the following side effects and complications. With autologous fat grafting: loss of volume as part of the grafted fat is absorbed (the degree of absorption varies widely by individual), fat necrosis and cysts, calcification (which may need to be distinguished on breast imaging), infection, bleeding and bruising, asymmetry, over- or under-correction, irregularity and changes in sensation at the donor area, and the possibility that an additional graft is needed. hADM may cause a foreign-body reaction, infection or seroma; HA may cause nodules and migration, loss of volume through absorption, and effects on the reading of breast imaging, and may need to be dissolved with an enzyme if necessary. Whichever method is used, there is a limit to the enlargement that can be obtained, and results vary by individual. We explain the risks that apply to you fully at consultation.
The content on this page is general medical information provided in accordance with the Medical Service Act. The results of surgery and treatments and the recovery period may vary by individual. All surgeries and treatments carry a risk of side effects, so please decide after a thorough consultation with a specialist.
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FAQ
Q1How much of the grafted fat remains?
Generally, part of the grafted fat is absorbed and the rest remains; the proportion varies widely by individual, depending on your constitution, the harvesting and injection method, and the blood supply at the recipient site. Fat that remains after 3–6 months is largely maintained, but it can increase or decrease along with changes in your weight.
Q2How many cup sizes can I gain?
The enlargement you can expect from a single fat graft is generally about half a cup to one cup. It depends on how much give the breast skin has and how much fat can be harvested; if you want more, we consider dividing it into sessions or using an implant.
Q3I am slim. Is fat grafting possible for me?
Without enough fat to harvest, it is difficult to create the volume you want. At consultation we check which areas and how much can be harvested, and if fat grafting is judged unsuitable, we guide you toward an implant or a hybrid method.
Q4Does it affect breast cancer screening?
Calcification or cysts that can form after fat grafting may need to be distinguished on mammography. If you tell the examiner that you have had fat grafting, it is taken into account in the reading, and ultrasound is added as needed. For the same reason, HA injection should also be disclosed.
Q5Which is better for me, fat grafting or an implant?
It depends on the enlargement you want, how you feel about an artificial implant, and how much body fat you have. If you want a small change and a natural feel and have fat available, fat grafting is often the fit; if you want an enlargement of one cup or more, an implant is often more suitable. We compare the advantages and disadvantages of both at consultation.
Q6How long does HA injection last?
It varies with the product, the amount injected and your metabolism, and it is absorbed over time. Because its duration is limited and repeat treatments are needed, if you want long-term volume we recommend considering fat grafting or an implant.
