The aim is the same, breast augmentation. The technique and end results are however quite different.
The well-tried gold standard is the placement of the implant under the breast tissue. There are many types of implants and they are placed at different levels, under or on top of the pectoral muscles. The results are now very predictable and make patients very happy. They feel more feminine and more confident and can wear a new range of attractive clothes. The implants themselves are now all made of silicone, an inert safe substance that we know all about.
There are implants for all occasions. Implants to enlarge, implants to correct ptosis (drooping) and implants to get over the one remaining issue of Capsule formation. This is where a firm fibrous envelope forms around the implant contracting to cause deformity and discomfort. This is the polyurethane foam-covered implant. The silicone implant usually contains silicone gel of varying consistency, but saline has been another option popular in the USA. Some of these implants tend to leak and collapse and their consistency is rather firm.
In summary, silicone implants can reliably provide a huge variety of shapes and sizes, but patients have to be aware that further surgery may be necessary also silicone is a foreign substance. It is inert and despite speculation in the past is very safe. Recently an extremely rare tumour has been associated with some textured implants. This is the anaplastic large-cell lymphoma (ALCL). Fortunately, it is curable.
The alternative is to enlarge the breasts using your own fat taken by liposuction from elsewhere in the body, processed and injected into the breasts. It is natural and not foreign material and therefore attractive to some people.
Fat is a huge reservoir of stem cells. Stem cells improve survival of the fat and have specific healing effects on the skin. So when we talk of stem cells, we often mean fat with its normal quota of useful stem cells. However, at the Cadogan Clinic, we have the facility to add extra stem cells. These are extracted from more fat which is not used for grafting. The survival of fat in good shape is greatly improved.
Fat does not have the complications of silicone but is limited in other respects.
Patients with small breasts are often athletic with little body fat. This limits the size of breasts possible, but even if there is abundant fat, the amount grafted is limited as the fat has to take up a blood supply to survive. Partial survival may give a lumpy result. A second or even a third operation may be necessary.
A big advantage is that the fat can be put in selectively to enhance the breast shape. This is particularly useful for filling breasts that have become slack after pregnancy or weight loss. In these cases, fat tends to be placed into the empty upper breast above the nipple. We also often put fat around breast implants to disguise a visible edge.
Breast enhancement with grafted fat and stem cells might be right for you if you are:
+ Seeking moderate breast size increase
+ Not planning to have children within the next year
+ Looking to refine the shape or fullness of areas of the breast rather than overall.
+ Prefer the naturalness of using your own tissue rather than foreign material
However, if you desire a significant change in breast shape or lift breast augmentation via silicone implants may be a better choice.
Discuss your desired end results with your surgeon thoroughly. They will help you understand all of the available options and what combination of procedures can help you get what you are looking for.
Silicon operations are still the golden standard for breast augmentations although stem cell-based breast augmentation is a good choice for patients in need of fat disposal who expect a minimal additional volume on their breasts.