Breast
Is Breast Augmentation the Same as Breast Implant Surgery?
Is breast augmentation the same as breast implant surgery? Breast implant surgery is one form of augmentation; fat transfer is another way to add breast volume. Darren M. Smith, MD, a board-certified plastic surgeon in New York City, explains the distinction and compares the practical limits of each approach.
In this episode.
Episode summary
Is breast augmentation the same as breast implant surgery? Breast implant surgery is one form of augmentation; fat transfer is another way to add breast volume. Darren M. Smith, MD, a board-certified plastic surgeon in New York City, explains the distinction and compares the practical limits of each approach.
Originally published October 7, 2020. Implant brands, preferences and cost comparisons in the recording reflect that period. Confirm current options and implant-specific information during consultation.
Key takeaways
🧩 Augmentation options
Augmentation describes increasing breast volume; it does not specify that an implant must be used.
🔎 Implant materials
Silicone gel and saline implants differ in their filling material. The recording notes that both have silicone shells, so saline does not mean silicone-free.
🔄 Fat transfer process
Fat transfer uses liposuction to collect the patient's own fat, followed by processing and placement in the breasts.
📏 Donor fat and retention
Available donor fat and how much transferred tissue survives limit the achievable volume. A general retention estimate cannot predict an individual's result.
🎯 Personal treatment priorities
Appearance, feel, desired volume and cost should be discussed together. Neither technique is automatically the right choice for everyone.
Questions this episode answers
Can breasts be augmented without implants?
Yes. The episode describes fat transfer as an alternative for selected patients. The person must have suitable donor fat, and the desired change must fit what the technique can reasonably provide.
Is fat transfer a nonsurgical way to enlarge breasts?
No. Using your own tissue does not make the procedure nonsurgical: the recording describes harvesting fat with liposuction and then placing it in the breasts. Risks and recovery still need an individualized discussion.
Can fat transfer provide the same increase as any implant?
Not necessarily. Dr. Smith explains that donor-fat availability and variable graft survival constrain fat transfer. Implant dimensions also need to fit the patient's tissues and goals; neither approach offers unlimited enlargement.
🔗 Related information
Compare current information about breast augmentation, fat transfer breast augmentation, and breast implant options, or schedule a consultation.
Educational information, not individualized medical advice. All procedures have risks; volume, recovery and results vary. Show notes updated September 30, 2026.
Original show notes
Board certified NYC plastic surgeon Dr. Darren Smith discusses different approaches to one of the most frequently requested procedures in plastic surgery.
Read the conversation.
[00:08] I'm board certified New York City plastic surgeon, Dr. Darren Smith, and this is plastic surgery before and after. Your source for the real deal about plastic surgery procedures, news about trends in aesthetic medicine, and candid sessions with industry insiders. We hope you enjoy today's episode. Is breast augmentation the same as breast implant surgery? Breast augmentation is any kind of procedure that makes the breasts bigger. So breast implant surgery is a kind of breast augmentation. There are several different kinds of breast implants and we've covered them in earlier episodes. But for a brief review, the most popular one in my practice is the silicone gel breast implant. And the next most frequently used is a saline filled breast implant. And the third kind that's a bit less popular, it's newer and not as well known, is called the ideal breast implant. And a silicone gel breast implant is essentially a silicone shell that is filled with a highly cohesive and soft silicone gel. It is the implant that looks and feels the most natural. Sailing breast implants, on the other hand, have a thin silicone shell, but they're filled with saltwater.
[01:33] They're essentially carefully shaped water balloons. And these implants tend not to look or feel quite as natural as silicone breast implants. But for individuals that are concerned about having silicone based implants, saline does provide an alternative. The ideal breast implant is supposed to offer the best of both worlds. It is a silicone shell that's filled with saline, but it also has layers of silicone sheeting inside of it, what are called baffles. And these are designed to prevent the saline solution from moving around as much. So the implant is supposed to look and feel more like a silicone breast implant while it just contains saline. In my experience, though, the best look and feel is still really achieved with a silicone based breast implant. So What is an alternative to breast implants? If you're looking to enlarge your breasts, one way to do this without having breast implants and really the only other reliable option is fat grafting. And we've covered the basics of fat grafting in earlier episodes, but essentially in fat grafting, we harvest fat cells from other areas of the body with some focused liposuction. We process the fat and to process the fat. We essentially remove any excess oils or other fluids and substances that we don't want to be re-injecting back into the body with the graft.
[03:15] And we essentially convert the harvested fat into a paste that we can then re-inject into the body, in this case into the breasts, to increase the size of the breast. So fat grafting is an alternative to breast implants as a way of achieving breast augmentation or breast enlargement. In terms of a comparison between breast implants and fat grafting, with regard to how good each strategy is to achieve breast augmentation, I'd like to run through a few specific points. First, in terms of the size of the breast enlargement that we can achieve with breast implants versus fat grafting. With a breast implant, you can essentially achieve as large an augmentation as you want.
[04:05] and you're limited only by the soft tissue envelope of the breast and what is aesthetically pleasing in terms of deciding on your implant size. On the other hand, with fat grafting, you can be a bit more limited because we can only use fat from the patient so if someone is very thin they won't have as much fat for us to use for grafting and unfortunately when we do perform a fat grafting procedure there can be significant loss of usable fat because because first not all the fat that we harvest is usable some can be damaged during the harvest process and is filtered out during processing and then we usually say that about 60% of the fat that we actually do graft survives. And the reason that...
[04:56] not the entire graft survives, is that we are, remember, transplanting living cells, and we're relying on those fat cells to become attached to the blood vessels in the recipient site, in this case in the breast, so that they can get the blood supply and the oxygen and the nutrients they need to become living tissue. And it's just simply a matter of odds that not all of the cells that we transplant are going to successfully engraft and live in the breasts. In terms of the appearance of a breast implant versus a fat graft, really a breast augmentation that is performed with either an implant or fat transfer, if it's done well, can look very, very natural. In terms of feel, most would probably say that a fat graft feels more natural than even a silicone breast implant because you are, in fact, just transferring natural tissue from the individual. There is no artificial implant to be felt when you're doing a breast augmentation with fat transfer instead of a breast augmentation with a breast implant. In terms of cost, this is something that's going to be highly variable. I would think that in a lot of cases, the cost would be pretty comparable between a breast augmentation with fat transfer versus a breast augmentation with implants, but this is something that would really have to be discussed with your individual surgeon. Another related question that we frequently hear is, how can I naturally enlarge my breasts? And that really depends on what you mean by natural.
[06:38] But since fat transfer is really using only your own tissue to perform a breast augmentation, a breast augmentation by fat transfer would be natural in the eyes of many people. Taking this question one step further, people often ask, how can I make my breasts fuller without surgery? And the answer to this one is there really aren't any reliable, non-surgical ways to increase the size of your breasts. But hopefully after listening to this episode, you've got some more information about the different options that are available to you in terms of ways to achieve a breast augmentation or breast enlargement that you're gonna really like. Thanks for listening, and don't forget to subscribe, share the show, and head over to darrensmithmd.com for more real-world plastic surgery talk.
Sources and context.
Original Captivate episode. Original release date: 2020-10-07. The recording is the source for the transcript and episode discussion. Later context in the written summary is identified separately.
Behind the conversation.
Darren M. Smith, MD, FACS