Answering questions about composite breast augmentation.

Dr. Shenker explores this popular new procedure.

The Cosmetic Surgery Clinic, Dr. Robert Shenker

The most popular cosmetic breast surgery procedure we’re doing at The Cosmetic Surgery Clinic right now is a called a composite breast augmentation. (I wrote a blog post about it in 2017.) It’s a procedure that uses both a breast implant and the patient’s own fat to create a beautiful, natural, perfect breast.

Because this procedure is a relatively new one and we are one of the only clinics doing it, we get a lot of questions about composite breast augmentation from the women we see in Waterloo from London, Guelph and throughout Southwestern Ontario. I thought I would take this opportunity to answer a few of them.

Do I have to use my own fat, or can somebody donate fat to use?

This is the most common question we’re asked. The answer is that it has to be the patient’s own fat that gets used. Donation from other people is not possible.

I don’t see a difference in the results of this technique, versus more traditional breast augmentation techniques. What’s the point?

We also hear frequently from people who can’t see a difference between photographs of implants placed under the muscle (in a more old-fashioned technique) and pictures of a composite breast augmentation. People inevitably wonder what the point is of using the fat at all. In truth, the fact that you can’t see a difference is exactly the point of the procedure.

Let me explain: in a traditional breast augmentation, the implant is placed under the pectoralis major muscle, a major muscle of the chest, which has to be cut and permanently moved to a new and unnatural position. The purpose of doing that is to camouflage the upper part of the implant to create a less artificial look. In a composite breast augmentation, the use of fat combined with an implant placed on top of an intact chest muscle eliminates the need to permanently destroy the muscle.

If the old technique of placing a breast implant under the chest muscle isn’t broken, why try to fix it?

Well, the fact is the old system is broken. Placing a breast implant under the major muscle of the chest does not come without consequences, such as:

  • The muscle will lose some of its power.
  • The muscle has to be detached from its bony attachments to the ribs and breast bone, and it can never be repaired.
  • When the muscle flexes with arm movement or exercise, it compresses and temporarily deforms the breast implant in an unnatural fashion, making it look very odd.
  • Cutting through the muscle can cause bleeding, additional pain, prolonged recovery and an unnatural swelling in the upper part of the chest for many weeks after surgery.

Doing a composite breast augmentation and leaving the muscle where Mother Nature put it avoids all of these potential problems.

What happens to the transferred fat if a patient’s weight changes?

The transferred fat acts like normal regular fat. That means if a person gains weight, the transferred fat will expand a bit and if a patient loses weight the transferred fat will shrink a bit. Some people see this as a disadvantage, but I actually see it as a positive. It’s almost like having a programmable breast implant that changes with you over time as your body changes.

Are there other advantages of including fat transfer?

Another obvious advantage of this procedure is that it allows a patient to combine breast augmentation surgery with body contouring through liposuction. The procedure requires a small amount of fat to be placed in each breast, and that fat has to come from somewhere on the patient’s body. Typically, I take the fat from the abdomen or the flanks or the thighs. This fat provides what is needed for the breast surgery while we completely recontour the other body part to supplement the aesthetic results of the breast surgery.

Fat transfer is a technique that continues to transform the world of plastic surgery as we know it. I use fat in a wide variety of my procedures these days. Combining it with a breast implant and leaving a woman’s chest muscle intact and undisturbed has been one of the most profound changes in my practice over the last number of years. This is now my go-to procedure for breast augmentation in appropriate patients.

If you are thinking about having breast augmentation surgery, this procedure might be right for you. Come in for a visit and we’ll talk about it!

Meet Our Surgeons

The talented, experienced plastic surgeons at our Kitchener-Waterloo clinic have the advanced training to create exceptional, natural-looking results that meet the individual needs of our patients. The collaborative nature of our practice benefits patients in many ways.

Dr. Robert Shenker Dr. Stephanie Ma
The Cosmetic Surgery Clinic