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Let me start by saying I had both as a result of breast cancer and a double mastectomy. I had the implants done first and then the second operation was the fat transfer. They took fat from my belly and used it in my breast. The fat made them look more natural vs “bolt ons” as folks like to refer to them. More natural looking and jiggly (if thats a word - think how Jello wiggles). For me, they put me in a binder (an elastic garment that stretches and holds you in). I was sore, not pain; and within a couple of days was moving around with more ease. For me I had to sleep at an angle (your situation may be different) and I couldn’t drive for 10 days (but keep in mind this was my situation). I did not think the fat transfer was bad. I have no idea as to cost because it was insurance - I had breast cancer. I will say this though - research your plastic surgeon! They really make a difference!! (Not sure where you are located, but if you’re near Atlanta, I can recommend!).
If you decide to want to consider Atlanta, the practice is called JC Plastic Surgery of Atlanta. Dr. Chang is fabulous, listens to her patients, talks TO you (not at you), and has a great bedside manner.
I don’t have experience with either but my niece had mastectomy, implants, then removal. She plans to do fat transfer. The implants were affecting her health. Her Dallas plastic surgeon said the trend is removal. There is a FB group dedicated to discussion, “Breast Implant Healing and Illness by Nicole”. Testimonies before/after. Beware each person has their own experience and some TMI detail, opinions abound, so filter filter filter.
My friend did fat transfer. She said it did not work and got implants.
Mentor
My mom had an implant leak and had to have them both replaced (and I personally know another person this happened to). My sister regrets hers and has many symptoms of implant illness, wants to have them removed asap but can’t currently afford the procedure. That’s just three people, there are thousands that have issues after implants. Based on that I would go for fat transfer.
Think it depends on how big you want to go right? It's my understanding fat transfer is only limited to a cup size or two.