Breast enlargement using implants requires anesthesia. A pocket is made above the rib cage and under the pectoral muscle. Then an implant is placed in the pocket and inflated. This can be performed with an incision around the nipple, under the mammary fold or through the axilla.
Implants are filled with saline or silicone. Fat is taken from one part of your own body, most commonly the thighs or abdomen, and after minimal processing is injected into the breast. My vote is definitely for fat transfer: it is natural and without the usual complications associated with implants.
Fat transfer is done under local anesthesia using tumescent solution and fat is taken from an unwanted area and transferred to the breast just under the skin. The breasts feel natural and it does not interfere with breast-feeding or mammogram readings. While implants can cause problems such as encapsulation, breakage and migration upward or downward, the fat transfer stays where it is placed. This fat remembers that it is from the thighs or abdomen and as one loses or gains weight, the breasts become less prominent or more prominent. They are totally natural and feel natural.