Breast Augmentation: The Ugly Truth About The Nonsurgical Option

Bridget Mulroy
Top NJ Cosmetic Dr. Ram explains the downside to nonsurgical breast augmentation.Photo by(apomares/iStock)

A study published by Very Well stated that breast augmentations/enlargements were amongst the top cosmetic procedures performed in the United States. According to the Cosmetic Surgery Global Market Report for 2022, breast augmentation remains one of the most commonly performed procedures amongst all age groups and genders. 

As with all procedures, there is a potential for dangerous side effects. Nonsurgical options are looking more appealing to individuals considering breast augmentations. However, contrary to popular belief, nonsurgical breast rejuvenation approaches (the most popular method currently being PRP/Platelet Rich Plasma procedures,) don’t hold a candle to the results of surgery.

Dr. Ram Chandra MD, one of New Jersey's top cosmetic doctors, explains further in hopes of clarifying the differences between nonsurgical breast augmentation and surgical.

Now when so many people are opting out of surgery, the demand for non-surgical cosmetic procedures has skyrocketed. Specifically referring to breast augmentations, the possibilities to achieve desired results are vast. Is a nonsurgical breast augmentation (in terms of procedure time, downtime, pain, etc) the same as other PRP procedures?

“Non-surgical breast rejuvenation is very different compared to that of the face. The structures we are dealing with are entirely different. Anatomy is different. One must understand that anything no-surgical will only give non-surgical results. Calling any non-surgical rejuvenation a “breast lift” or “breast augmentation” is misleading as people will incorrectly think they are getting a breast augmentation without surgery. Sounds like a good deal, but it is not! Embryologically breast is a modified sweat gland. Most of it consists of fat predominantly, in addition to fibrous tissue, and milk-producing mammary glands, sitting on pectoral muscles and something called “loose areolar tissue”, allowing the breasts to glide smoothly. So, anything that replaces this structural component will never be perfect!”

With so many ways of performing a nonsurgical breast augmentation, what is your preferred method of achieving a patient's desired results?

“If the patient’s desired result is augmented breasts similar to implants, they will be disappointed. In general, we can improve the appearance and fullness of cleavage, improve the texture of the skin, get rid of UV-induced damage, and also improve the sensitivity of the nipples. For this, we use Platelet Rich Plasma (PRP) from the patient’s blood, a very small amount of hyaluronic acid fillers (1-3 ml max, compared to 250-500 ml of Macrolane HA fillers they used in Europe!), IPL, lasers, PDO threads, and chemical peels to improve the appearance of overlying skin itself. Doctors have also used fat transfers from other areas of the body, but results are not always encouraging due to the varying viability of the transferred fat and asymmetry. One must know that many women have breast asymmetry normally.”

With a surgical breast augmentation ranging in cost around $10k, how does the nonsurgical route stack up in terms of cost and results lasting?

“Nonsurgical approach does not come anyway closer to the surgical approach.”

Are there any potential adverse side effects?

“Every procedure has side effects, surgical or non-surgical. Unsatisfactory results (if you can call that) can be a side effect of a non-surgical approach. Using too many fillers is not only very expensive but can also potentially cause migration of the fillers. Using only 1-3 ml of HA filler just in the cleavage area, especially if it is blended with PRP, is very unlikely to cause migration. With this process, tissue integration is better and more complete. Bruising and hematoma could be temporary side effects from the injection itself. With good aseptic precautions, infection is rare but not unknown. On the other hand, implant surgery has also familiar side effects: scarring of the surgery however it is a hidden, bacterial and fungal infection, rupture of the implant, “implant show” (rippling of skin), unnatural appearance, need for revision, and sometimes even removal. Both procedures also can interfere with the interpretation of mammograms and early diagnosis of cancer. Recently the skyrocketing gender-change-related-implant surgery has increased the reported side effects, with many regretting the procedure eventually. It is easy to understand when we know that in a biological male, one is placing the implant directly under the skin. The non-surgical approach has no useful application in a biological male with breast implants. Implants of any sex need regular follow-up and assessment and might need revision after some years.”

While no two patients are the same, is there an advantage of a PRP (vampire) breast augmentation compared to using filler? Recently it seems like HA filler is preferred to perform non-surgical breast augmentation, is it the safest? (see the national library of medicine link:

“PRP is natural and will stimulate the rejuvenation of the native tissue (fat, blood vessels, collagen, etc) where its injected, but this is not sufficient enough to give augmented results. This must be emphasized. Using too much filler (like 250-500 ml of Hyaluronic acid) is unnatural and in my opinion, the body can not integrate it as it can be an autologous fat transfer. With such a large amount of filler, there is a chance of infection, compression of surrounding tissues, and migration. Pectoralis muscles are always very active and they are strong, hence a large amount of an unintegrated filler is likely to migrate. Macrolane HA filler for breast augmentation was withdrawn from the European market in 2011 and it never entered the US market.”

Who can perform non-surgical breast augmentation? What are some things to look out for during consultations for non-surgical breast augmentation?

“As I mentioned before in my opinion there is no “non-surgical breast augmentation”. However, “Nonsurgical breast rejuvenation” is best performed by physicians who understand the anatomy, physiology, and interactions of the breast tissue and know the limitations and precautions. It is not an aggressive or overtly invasive procedure.”

Is there a limitation when performing non-surgical breast augmentations? (ie size, proportion, safety, etc.)

“If the breasts are widely apart, too small, too saggy, with a significant lack of tissue in the cleavage area, it may not be possible to get a full satisfactory improvement in the cleavage. We need some tissue present there to stimulate and work with. It’s the same as PRP hair rejuvenation: if one is completely bald PRP will not work. They first need a hair transplant and then the “fertilization” of the transplanted hair with PRP. “Implant show” can be improved with PRP blended with a small amount of filler.”

Are these procedures ideal for breast cancer survivors who have lost breast tissue or undergone changes to the physical appearance of their breasts?

“Typically implant is placed at the same time as a mastectomy for breast cancer. The non-surgical approach has no role here.”

How do you feel personally about being able to help people achieve confident results without having to subject your patients to anesthesia?

“By discussing the limitations that we talked about before, and by making them understand that the two (non-surgical and surgical) are not comparable, many patients can make a decision that best suits them. A full consultation is a must.”

You can read more about PRP procedures and the ones offered by Dr. Ram Chandra MD at Anara Medspa here:

Previous stories with Dr. Ram Chandra MD:


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