# Breast Implants or Lipofilling in Augmentation Mammoplasty? A Randomized, Open-Label, Controlled Trial

## TL;DR

This study compares breast implants and fat grafting for correcting underdeveloped breasts, finding both effective but with different aesthetic outcomes.

## Contribution

A randomized controlled trial comparing implants and lipofilling for breast hypoplasia with detailed aesthetic outcome analysis.

## Key findings

- 87.5% of implant patients had excellent aesthetic results after 12 months compared to 70% with fat grafting.
- Implants provided more lasting results, while fat grafting gave more natural outcomes.
- Both methods were safe and effective, but with distinct advantages in specific deformities.

## Abstract

The author presents his own experience using breast implants (BIs) or fat grafting, commonly called lipofilling (LPF), to correct breast hypoplasia.

Compare the aesthetic results obtained in a study group (SG) using BIs in breast hypoplasia correction with those of a control group (CG) treated with LPF, analyzing the influence of breast and chest deformities (tuberous breast, breast volume differences/asymmetries, nipple–areola complex asymmetry, pectus excavatum, and carinatum) in the outcomes.

A randomized, open-label controlled study was performed. A total of 95 patients affected by breast hypoplasia (SG) were treated with BI, comparing results with the CG (n = 90) treated with LPF. The pre-operative analysis was conducted through anamnesis (considering also the patient’s expectations), clinical and photographic assessment, and an instrumental evaluation based on magnetic resonance imaging, mammography, and ultrasound. Post-operative follow-up occurred at 1, 2, 4 weeks, 3, 6, 12 months, and then annually until the fourth year.

87,5% (n = 83) of SG patients treated with BI showed excellent aesthetic outcomes after 12 months compared with the CG patients treated with LPF, who showed the same results in 70% (n = 63) of cases. Breast augmentation maintenance in the SG was significantly higher than in the CG (p < .0001). However, more natural results were reported in the CG than in the SG (p < .0001).

BI and LPF were safe and effective in this controlled trial. CG's patients displayed more natural results, obtaining a better pectus excavatum correction, while SG’s patients showed more evident and lasting results.

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The online version contains supplementary material available at 10.1007/s00266-025-05204-0.