July 9, 2019Expert Perspective

Everything You Need To Know About Hybrid Breast Augmentation

This latest plastic surgery trend combines breast implants with fat transfer for a more natural looking bust.

Karina Giglio

From the car dealership to the beauty aisle (hello, makeup-skincare combos!), hybrids are everywhere, so it should come as no surprise that the dual concept has made its way to the plastic surgeon's office, too.

While "boob jobs" remain one of the most commonly performed cosmetic surgery procedures in the United States, aesthetic trends and surgical techniques have evolved. Requests for DD-cups have given way to women looking for more natural breasts (think: B- and C-cups — or even fuller A-cups). In turn, doctors have started offering procedures, like fat transfer-based augmentations, aimed at creating a more minimalist result.

But what if you are in search of a Goldilocks-like breast size that is neither too big nor too small? Enter: Hybrid Breast Augmentation.

The Philosophy

Hybrid breast augmentations are quickly becoming a go-to for patients looking for a more customized outcome. "No two breasts are the same, and implants are essentially a rough tool to create additional volume in aesthetic shapes," says Jacob Unger, a board-certified plastic surgeon practicing in Nashville, Tennessee. "If you want to fine-tune the overall shape, position, and size discrepancy between breasts, fat grafting is the way to achieve that. It allows me to camouflage contour irregularities, deformities, or thin soft tissue coverage.”

Gregory A. Buford, MD, a board-certified plastic surgeon in Englewood, Colorado, agrees. As a proponent of fat-based augmentations, he believes the hybrid procedure offers the ability to create an even more optimal result.

"A combination approach of implant augmentation along with fat grafting offers the ability to increase cup size more dramatically than with fat grafting alone, as well as the ability to more effectively localize contouring with fat as compared to an implant alone," he explains. "Fat can also be used very effectively in patients with very little breast tissue as a barrier between the implant and the overlying skin to decrease the chance for rippling."

The Procedure

As the name suggests, the hybrid surgery is a two-part process that has a slightly longer recovery time (a couple of weeks) and higher cost than a standard breast augmentation procedure because both an autologous fat transfer and implants are involved. It should also be noted that anyone considering a hybrid breast augmentation must actually have enough excess body fat to graft. "The challenge, especially in places like Colorado, is that many of our patients present in very good shape and with little body fat but still want to pursue fat grafting," Dr. Buford warns. "If there isn't any appreciable fat, then this procedure will not be possible."

Once a person is determined to be an ideal candidate, a surgeon performs liposuction to remove the patient's own fat from an area like the outer thighs, buttocks, or abdomen (yes, the bonus here is that you take fat out of the areas you don’t want it and add it back in where you do). The fat is then processed to remove impurities and concentrate stem cells.

When it comes to selecting an implant, surgeons often choose a smaller one than they would in a non-hybrid augmentation and supplement it with fat for a true “did she or didn’t she?” effect. If there’s a limited amount of fat to use, however, the patient and surgeon would choose an implant that matches the desired cup size and anything grafted would be used for further detailing. “The fat would then be used to perfect contour and symmetry in a manner you just can’t achieve with implants alone,” Dr. Unger says.

The Results

By increasing the breast volume with both an ideal implant and autologous fat, the hybrid breast surgery is feted for its personalized, natural results. But, as with any procedure, it is important to find a board certified plastic surgeon that specializes in both fat grafting and breast reconstruction to avoid complications.

"Fat grafting to any area of the body can create very natural results, but it is also a procedure that should be left in the hands of an experienced surgeon. The most common downside of fat grafting in this area is a 'low take' of the fat long term," says Dr. Buford. "Asking the right questions from the start is essential and could potentially mean the difference between a result that is natural and long lasting and one that is not."

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