Do I Need Breast Implants Or Fat Injections?

Q:  Dear Dr. Eppley, my breasts are slightly droopy and I want them to be more perky. I thought I needed a lift but one doctor that I consulted with said that I needed more volume in my breast instead of a lift. He said this could be done with an implant or fat injections. The length between my nipple to sternal notch is 22.5 cm. Should I have breast lift or breast augmentation? If augmentation is best, which treatment is better an implant or fat injections?

A: The key to knowing whether a lift or the addition of volume can make the breast look better depends on the position of the nipples. If it sits above the lower breast fold, then volume is the answer. While I do not know exactly what your breasts look like, knowing that the distance from your nipples to the sternal notch is only 22 cms tells me that your nipples are definitely above the inframamammary folds. That is essentially a completely normal or ideal nipple position. (the normal range is 18 to 22 cms depending in the length of one’s torso)

Since more breast volume is the answer, the question of whether it can be done with an implant or fat injections becomes very relevant. The use of fat injections for augmentation of a variety of body areas has become very popular in plastic surgery recently. While it is widely accepted for volume augmentation of the face and buttocks, its use in the breast is currently controversial. This is because there already exists an augmentation method that works well and is very reliable, an implant. For overall breast augmentation, an implant works better, is a one-step procedure, and will cost less. If there is just one area of the breast that needs filled in, then fat injections becomes the preferred treatment.

Dr. Barry Eppley

Indianapolis, Indiana