Breast Augmentation – is there another way?

Before a Breast Augmentation you MUST do your homework…

We are approaching 50 years since implants manufactured from Silicone were first used to augment the female breast. In that time, hundreds of thousands, perhaps millions, of women have undergone this surgery, and for many it has been a rewarding experience. During that time there have been many changes both to the implants used and to the way in which the surgery is performed. But perhaps the most significant change has been the increase in size of implant demanded by women. It seems that the desire for size is insatiable! Whereas in the early days it was rare to use an implant with a volume of more than 200 cc, currently volumes of 400 cc and more have become common place!

Breast augmentation with implants has become heavily commercialised not only by implant manufacturers but also, unfortunately, by plastic surgeons. Marketing always “sells the dream” but this seldom relates to the reality. With websites promoting excessively large breasts, women are led to believe that this is what they should have and yet we all know that larger implants will only cause greater problems in the future.

In fact the reality of breast augmentation with implants is that all implants will eventually need to be removed or replaced. This is due to deterioration of the wall of the implant, adverse effects on the surrounding tissues or simply because they are too large.

When I review some of the complications and adverse effects that I have seen in my practice, I wonder whether future generations of plastic surgeons will look kindly on this period of our history.  For example here are some of the adverse outcomes that I have seen in my practice over a short period of time. Adverse outcomes are particularly common when the implants have been inserted overseas or at a “cut price” clinic. The complications range from excessive size, malposition, asymmetry, seroma with possible ALCL and implant extrusion.


Is this the look you want? Or are the implants too large and too high on the chest?

2 uneven breast implants

Is this a good result? Or are they uneven with the left implant too low?


Would you be proud of this result?


What if this happened to you?- A case of seroma with possible ALCL.

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A victim of cut price surgery. The surgical scar has broken down with infection around the implant. Both implants had to be removed. How would you feel if this happened to you? Is cheap surgery worth it?

So, is there a better way?  In recent years I have been investigating the possibility of using autologous fat to augment the breasts. This means taking excess fat from the hips, thighs or abdomen and, after preparation, grafting the fat into the breasts where it is able to grow. There is no doubt that this is a very specialised procedure but the results have been very rewarding and far better than anything achieved using implants.

After Fat Transfer

After Fat Transfer

After Fat Transfer

These are just a small selection of “before and after” pictures of women having breast augmentation by fat transfer.

Some people are sceptical! What do you think?

Written by Mr Allan Kalus, Senior Surgeon at Avenue Aesthetic Surgery.