How do you choose a good surgeon for this procedure? Is this procedure the same as it was many years ago or has it changed?
I do not routinely perform fat injection for primary breast augmentation. I prefer to use implants for a more consistent long-term result. However I will perform fat augmentation for patients with signs of rippling who have very thin soft tissue envelopes. I will also use it for revisions on breast reconstruction patients.
I perform fat transfer for a primary breast augmentation when the patient is only wanting ~1 cup size increase in size and a very natural shape. I also routinely fat graft the upper pole as part of a mastopexy if the patient does not want to be larger but desires a fuller upper pole or closer cleavage.
I think like with most things we get better with time as we figure out what works better as far as harvest and survival.
Fat transfer to the breasts is becoming more popular as women are looking for natural ways for a modest augmentation. Also I think the brazilian butt lift (adding fat to the buttocks) has increased the popularity of adding fat to other parts of the body. I recommend choosing a surgeon that does a lot of fat augmentation. I use fat commonly for buttocks, breasts and face. The fat harvesting and injection techniques have improved over the years, increasing the longevity (fat take) of the injections.
I agree with the comments on this thread. We very frequently perform fat transfer to the breast. However, it is really only capable of increasing a woman's breast size by about 1 cup. However, it can be repeated multiple times for further enlargement. Good luck!
Choosing a surgeon for this procedure should entail a discussion of how frequently your surgeon performs breast augmentation using only fat grafting, and their long-term results. View your surgeons own patient photographs. And discuss your specific expectations asking him or her whether these are likely to be met. Speak with a few experienced board-certified plastic surgeons to help get the results you want, or decide whether the procedure is for you.
Many surgeons use fat graft as an add-on during breast reconstruction or lift, but fewer use it for primary breast augmentation. There have been minor advances in harvesting, processing and placement of fat in the last decade. As you may have discerned, this procedure has not replaced implant based breast augmentation because of various limitations including consistency of results, proportion of graft survival, possibility of lumps or unfavorable mammography changes. Best wishes for your search.
Be sure to choose a surgeon with experience in both implants and fat grafting.