Fat grafting is not an alternative to breast implants. And here’s why. Firstly, fat has no structure, so whereas an implant can help shape your breast, fat grafting can’t. Secondly, uptake of fat. The more fat you inject, the less will survive. Think of your breasts as a sponge. There is only so much fat that it can absorb. And finally, most women seeking a breast augmentation have very few donor sites. Harvesting fat in these women will leave complex irregularities that can’t be fixed. So when do I use fat graft in the breast? Firstly, skinny women to help camouflage the implant. Secondly, correcting minor asymmetries and finally to increase cleavage. One thing to note is to be careful when looking at early post-op photos of fat grafted patients. These always look great. You need to assess them at at least six months to see exactly how much of the fat has survived.