Silicone or saline have been the standard for breast implants but there may be a natural alternative to choose from. Fat grafting could be a new approach to more natural-looking breasts.

In a study led by Roger K. Khouri, MD, from the Miami Breast Center, 81 women underwent the breast augmentation procedure using fat injections. Not only was the method safe but the results were similar to other types of implants while also having a more natural appearance.

For nearly 20 years fat grafting for breast augmentation was banned because of possible concerns in regards to detecting breast cancer but that ban was lifted after studies showed that fat grafting did not interfere with breast cancer detection. Using fat as an alternative type of augmentation has been an attractive idea, but previous studies have shown that the fat does not survive long after injection.

The previous method of fat grafting involved gathering fat via liposuction from one area of the body which was then injected into the breast. Using this method, only 55 percent of the fat survived. The fat did not survive because there was not enough room in the breast for the fat.

In order to overcome this problem, researchers developed the BRAVA device, which is a suction-pump bra. BRAVA slowly expands the breast using the suction device, acting as a vacuum to create room inside the breast for fat transfer. BRAVA creates the extra room needed for the fat transfer while also creating an ideal environment for the fat to survive.

In the study, the women used the device for four weeks before surgery. Fat was then then injected in 10 to 14 sites. The participants wore the device for a week after surgery. The doctors monitored the 81 participants for at least 12 months, on average monitoring the participants for around 3.7 years.

Using the device improved fat survival by 27 percent, from 55 percent using the previous method to 82 percent.  The device also increased the overall size of the breasts. The previous method, using fat transfer alone, increased breast volume by 130 cc. The device increased breast volume by around 230 cc.  Using fat for breast augmentation also gave the breasts a more natural look and feel.

There were no major safety concerns from using BRAVA in addition to fat injections. The procedure is non-invasive, with no incisions or scarring. Recovery from this surgery is approximately three to five days.  According to Dr. Khouri, the BRAVA and fat injection procedure could be used for cosmetic purposes as well as for breast reconstruction.

The study was published in the May edition of Plastic & Reconstructive Surgery.