Breast augmentation without implants

Posted on February 22, 2010

This is the age old question.

How can we make breasts larger without a foreign object?  They have tried all sorts of things in the past.  The issue with many of them is:

1. Screening of the breast for cancer

2. Injury or hormonal stimulation to the breast- could it cause cancer or make a cancer which is there grow faster?

There are medications which claim to make the breast larger.  Be careful of anything hormonally based.  Many “herbals” are basic forms of  hormones and are as potent as the prescription strength hormones you get.

There is a machine BRAVA that applies suction, causing the tissue to swell and get new blood supply to make the breast larger.  It does seem to work, but it requires 11 hours a day for a median period of 18.5 weeks to go up about 100cc.  It has been around for over a decade and never got traction in the cosmetic market.  Why? To quote a plastic surgical colleague of mine, “The patients hated it. It required a lot of nursing time and assist because it was difficult to use, and the results were not impressive.”  But now, BRAVA, the “machine looking for an indication” may have found it.  It may help fat survive when transferred to the breast to do breast augmentation using fat.

Fat injections may be a promise in the future.  Really thin women don’t have enough fat to harvest, so for them, this will not be an option.  For others, it may.  I went to a recent meeting (Feb 2010) in Miami with surgeons who are innovative in the field.  The main issue still remains, how do you get the fat to survive reliably? How can you make sure it is safe? How much does it impair the ability to screen for breast cancer?

I will continue to blog about fat grafting to the breast, or as some believe, “stem cell breast augmentation.”  I am just not sure yet I am ready to do it.  My base question always with patients is would I recommend it to a family member? And as of now, I wouldn’t feel comfortable telling them I know it is safe.  But with more research, time, and hard scientific data, I believe it may be.

(NOTE: This is a hot topic.  Beware of untrained doctors who call themselves “plastic surgeons” who are doing fat grafting to the breast.  We do know fat grafting when done poorly has poor survival, causing oil cyts, hard nodules, and calcifications.  You can also easily get into the wrong plane and cause a pneumothorax, or the possible risk of fat emboli.  This is only a technique which should be done by experienced board certified plastic surgeons.  We do breast surgery, from breast reconstruction to lifts/ reductions/ augmentations, and we trained as general surgeons (doing mastectomies, etc) prior to plastic surgery.)