Fat chance: Has the time for breast enlargement with fat injection arrived?

The annual meeting of the American Society of Plastic Surgeons (ASPS) is just about to wrap up here in Seattle. As a member of the Emerging Trends committee, I am involved in putting on the “hot topics” session, which always has a few zingers. I’ll be posting on some of those in the coming days, but the question of whether or not it is safe and effective to use one’s own fat for breast augmentation is front and center.
It’s a simple idea: why can’t we just take some fat out from the bottom, or the love handles, or some other area where it isn’t wanted, and use it to enlarge the breasts? Certainly, there can be no more natural means of breast enhancement. In recent years, techniques for fat grafting have improved a lot and they are being used to improve the results from breast reconstruction and some cases of implant augmentation, by smoothing out contours and irregularities. Why not just do it for the entire breast in the first place?
At the meeting there were a few reports of some success, but also a few cautionary notes. For one, the volumes used are low, with no more than a cup size or so of enlargement possible. Concerns about the grafts leaving lumps that interfere with mammograms seem to have been addressed, so that barrier is coming down. But a French surgeon reported some evidence from animal studies that it is theoretically possible that the grafted fat could stimulate breast cells, resulting in an unknown effect on the risk of breast cancer. There is no evidence of this in humans, but it is a sign that we should proceed cautiously. So stay tuned, but don’t expect every plastic surgeon to be offering the procedure in the immediate future.