As a physician who strongly believes in informing his patients, I feel it is important that I comment about all the attention that the media has given over the last few years to fat injection to the breast. Most recently, that attention has been directed to the 24-Hour Saline Breast Augment and — by the same plastic surgeon — the Vacation Breast Augment.

Fat injections in lieu of implants for breast enlargement or augmentation surgery has become more and more mainstream.  It is not unusual for patients seeking consultation for a breast implant to question me about the possibility of injecting their own fat into their breasts instead of placing a breast implant.  On the surface, this seems like a reasonable idea.  In fact, many of my colleagues for whom I have great respect do this on a regular basis.  It is my opinion, however, that fat injections to the breast are not a good idea. In fact, there is some evidence that they may be dangerous.  There is both research and clinical data that suggest that women should proceed with extreme caution before they consent to these procedures.

In the laboratory, it has been shown that mice breast cancer cells grow at a much faster rate when they are mixed with stem cells.  Fat is one of the best sources of stem cells and may in fact have much greater numbers of stem cells than can be found in bone marrow. At the recent meeting of the American Society of Plastic Surgeons in Chicago, a paper was presented with data that revealed that fat injections to the breast made approximately a third of those patients’ mammograms more difficult to interpret.

I find the 24-Hour and the Vacation Breast concept even more difficult to fathom from a clinical perspective.  These are invasive procedures with effects that last only 1 – 3 days.   No matter how short the benefit, the potential risks of bleeding, scarring, calcification and infection remain present.  Weighing the risk-to-benefit ratio in my own mind, these are not procedures that I could ever offer to my patients.

I have implanted thousands of breast implants in my career.  The difference is that the implants are placed in pockets created below the pectoralis muscle or the breast itself —  not within the breast tissue.  Although those procedures require sedation, they are also, expected to last for years, which may alter the risk-benefit analysis.

As far as I am concerned not only is the jury still out on aesthetic injections to the breast, but the proponents of those procedures have not presented a strong case.