Fat Graft Transfer and the Radiated Breast
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hjpz: Send a private message to geewhiz. A number of women have had fat graft transfer procedures performed PRIOR to the exchange surgery.
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Thanks whippetmom - my PS was not in favor of it when I asked today...
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Hipz I did my fat grafting prior to exchange, I actually did it after I had to have my left TE removed due to infections. My lefty is my radiated and "problem child." I did the FG to help the skin on the left to maybe take a small implant one day without any issues. I did get a little mound out of it and some upper pole fullness so I look more normal in a tee shirt when I wear my prosthesis. I think the skin is better but until I see the PS the end of this month I can't be sure. You can PM me with any specific questions you might have.
Babs
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Thanks so much Babs!
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I just coincidentally checked this thread as it popped up tonight - and saw my name! I was just driving home from FL tonight and was annoyed at having to adjust my seatbelt which was pinching my chest...and then I smiled. I can feel my chest!! It's been a long road ... but I can feel my breasts again!! The skin is healthy and pink on both sides- radiated and not. I know I would not be where I am without fat grafting and these nutty eccentric doctors willing to push the envelope a bit.
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Bump.....
And geewhiz.....thank you!!
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I'm 9 years post lumpectomy and radiation, so it's nice to hear about someone doing the fat transfer after the same amount of time. I'm in my mid-fifties but look and feel younger, very healthy. Just weigh a little more than I want to and losing the weight before proceeding. Was so thin before that will probably keep a little extra for fat transfer, but not sure how much to keep. Was 18.5 BMI before and now am about 22.5 BMI, normal they say but big for me as my frame is made of very thin bones, small wrist, tiny ribcage, etc. Maybe instead of losing 20 lb, I'll lose 10 and end up at 20.5 BMI? I totally know what it's like to live with a prosthesis and am ready to ditch it. Is there a standard BMI you need to be at for fat transfer? Guessing it must be individual. When I'm 18.5, there doesn't seem to be much fat anywhere except my breasts. Mostly muscle as I hike and do small weights.
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Hi all.....I had my exchange surgery with fat grafting yesterday. My tummy is pretty sore!! And when I take the abdominal binder off it looks like I got beat up bad?!! Feels a little puffy and swollen. Is that normal???
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Yes! Totally normal. Horrible for a few days, but so worth it in the end! Hang in there!
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CLYDAY - I had quite a bit of fat grafting done last Wednesday and I looked like someone worked me over with a baseball bat. A little better than a week later, I'm nearing the final stages of bruising with mostly yellows and browns - with just a touch of green and purple - strictly as accent colors, of course. LOL! You'll look worse than you feel - hang in there!
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Bump
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Hello ladies,
I had DCIS 5 years ago, lumpectomy and rads. I had Fat Grafting done on Nov 17th on my lumpectomy side (left). I had a small area of calcification crop up on a mammo the week before the procedure, so had a biopsy done on the right side---benign fibrocystic changes. Due to the bruising from the stereotactic biopsy, I could not get fat grafting done on the "healthy side".
My PS did such a great job. I am slender-- about 5' 6", 117 lbs, very muscular. He extracted 80cc and placed in my left breast. It smoothed out my crescent shaped scar, and added volume to the lower portion of my breast, creating more symmetry with my other side.
I had really hoped to get FG for upper poles as well, but am wondering how the can extract enough fat to do so. Also mentioned getting implants done on both sides, but others have cautioned me on that--- (non physicians) basically not so safe to place implants unless you do mastectomy, etc, etc.
Would love to hear stories from anyone in similar situation-- where you've had a radiated breast, no mast, but opted for FG and implants. I consult with my PS on Jan 20 again to see if we need to do another FG session.
TIA for any advice or anecdotes.
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Marianna: I am not so sure about implants. Definitely they would need to be submuscular - under the muscle - but I think I would consult with a breast surgeon and a plastic surgeon about this. I am happy that the fat grat transfer rendered such positive results though
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Hi Ladies!!
I just had my 3rd grafting session. My thighs are not happy with me!!!
After losing my implant on the radiated side to an infection in February my PS did a fat grafting in May. Then because the results were so positive, he did another fat grafting at the end of August and placed a TE at the same time but left it empty. We waited 6 weeks and then started small fills. It was up to 260cc and a couple weeks ago, 12/22 he did another round of fat grafting where he removed 50cc from the TE and then grafted fat into that space and more. He did the left side as well for upper pole and cleavage and altogether moved over 500cc.
We are again waiting for the fat to settle in and then we will start the small fills again. Usually around 60 at a time until we match the other side that I replaced with a 600cc implant. Because of the fat grafting the right implant will be considerably smaller than that though!
I can tell such a difference in the radiated tissue and my PS is really pleased. He was a little reserved and cautious at first, but he is really pleased and may offer a friend of mine fat grafting on her radiated MX site. She had no recon at the time of MX and he is willing to try implants for her to with fat grafting!
Best wishes to all of you working through treatment, recon or getting back on your feet!
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4sew, cool how your PS is doing your fat grafting! So happy for your success!
I have had a total of 4 fat grafting surgeries, 2 before and 2 after rads. My most recent one was just over a week ago. I am doing total fat grafting with Brava, no implants. On this last one she did a mini-RAFT (pull some healthy abdominal skin up to the lower pole of the breast) with a fold recreation (I lost my fold at time of MX - it happens fairly often).
Doing well. Rough go of it at first and the fold gave me some sharp pain one day, but no major symptoms now. Just soreness.
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WOW 4sew - what an awesome post!!!! I am so very happy for you! You have had such a long journey you deserve this!
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4sewwhat: Wish every plastic surgeon would take the plunge with FGT for a patient with a history of radiation.
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Whippetmom
I agree- all PS should use FGT with patient's who've had radiation. For me, it made all the difference !!!!
Babs
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Thanks Ladies!!
I would not have know where to start if it had not been for Deborah when I was so upset after losing my implant! And I do LOVE my PS. See him Thursday so will give an update then. I need to get my pics posted too.
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So glad to have helped you 4sewwhat!
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Encouraging to read positive results from FG on radiated breast! Thank you all for posting!
I lost my implant on radiated side because skin was too thin. PS is encouraging LD flap now, but I dont want such an invasive surgery and long recoup. I would be fine with small implant on that side. I am not that concerned with a 'matched pair', but I would like something, not to be concave.
He is not happy with my choice, - he wants perfectly matched pair, and doesnt see why i would want to undergo 3 procedures (2 FG, and then an exchange) rather than one LD flap.
I am so uncomfortable with the TE in. I so want to be done with all this!
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Another
I did what you want to do and am really happy. Why don't you PM me
Babs
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anotherNYCgirl - Dr. Ahn is in NYC and specializes in fat grafting, including recreating an entire breast from fat grafting alone, no implants. She has done my last two surgeries and I LOVE her. If you are considering a new PS, you may want to get a consult with her.
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Dancetrainer, - Thank you for the recommendation. I looked at Dr Ahn's website and she seems wonderful. It is encouraging to know that you have such good results! For now I am working with another excellent PS. I am already having insurance issues and have spent thousands out of pocket. I doubt that I can afford seeing another dr, but I will keep her in mind. Thank you so much, - and I wish you all the best!
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Thank you NYCgirl - wishing you all the best, too! And I understand the insurance issues. I've spent a buttload of money since 2011.
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I had Fat Grafting done in November..... I am 5 years out from DCIS, lumpectomy and rads. I am quite slender, and my surgeon told me he could only get 80 cc out of my abdomen. We inserted it into my breast, and it did create some symmetry, and initially was nicely matched to other side, but sadly I went on a business trip where I did not eat properly and I ended up losing a few pounds. Well, guess where I lost the pounds?
So, my surgeon was not pleased, mainly because his success rates are so high. To have made a significant error to lose weight resulted in him telling me I am not a candidate for further treatment, as he believes aesthetically I will have major divots and disfiguration if we decided to remove fat from buttocks, legs.
I asked about implants, but he cautioned me strongly against it. We meet every 3-4 months, so will discuss at another juncture, but he felt strongly I was making an emotional decision to go with an implant.
It is an emotional decision, simply because I am completely flat on one side (rads -- the gift that keeps giving) and the nipple is pinched in appearance, slightly pulled to the left.
Would love to hear successful stories about implants after lumpectomy + rads.....
p.s. the fat grafting is GREAT, btw. I wish I had done it earlier, when I was a full 15 lbs heavier. I could have made myself a new breast at that point!!
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bum
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Hi everyone,
I am new at this so looking for input on fat grafting to soften radiated skin vs. a flap surgery... Has anyone had luck with this? I have gone for 2 opinions. # 1 Wants to do LAT flap, expander and only uses anatomical implants. #2 wants to do 6-9 months of fat grafting to restore radiated skin, expander, implant and NO flap if possible. I am 23 and have had no reconstruction, I have to wait because I had inflammatory BC and now taking a clinical trial drug for 9 more months. As soon as that is done I want to start reconstruction ASAP. Looking to hear from anyone who has done the fat grafting with no flap and if it is worth the extra time. This has been very difficult for me to be without reconstruction as I am sure it is for others. I just want to be reconstructed and back to somewhat normal! I would love to hear from anyone who has had great success with the fat grafting. Does it limit the size you can be? I would just like to be a full C cup as I was before. Thank you for any experiences you can share with me.
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Madison,
I have done fat grafting on a radiated breast - I'm trying to reconstruct completely via fat grafting as all plastic surgeons I have consulted with have told me my radiation damage is too severe to even consider implants. I am too afraid of flap surgeries so have ruled those out. I definitely did not want to do the lat flap as I felt it would affect my arm function (I use it extensively for dance fitness). So, I am thankful that fat grafting only (using Brava for expansion pre-surgery and healing post-surgery) is available to me.
The fat has done WONDERS to heal my skin and the subcutaneous tissues. My shoulder motion as a result is significantly improved. I am a huge proponent of fat grafting to help restore radiated tissue.
That said...fat grafting only is a LONG process. It requires multiple surgeries. I have had 4 and still need 2 more and likely will only get to a B cup. I have been at this for several years.
But I know you are considering fat grafting WITH implants. Some have done successive fat grafting then implants after radiation with success. Hopefully your radiation damage is not as severe as mine, and you can go that route. I hope those who have gone that route will speak up and share their story! The risk of capsular contracture with implants after radiation is very high, but some have done it. You are smart to research this carefully and weigh all of your options.
I am sorry you have to go through this at such a young age. It was hard enough for me when I was diagnosed at 43. But you will push through! There is a light at the end of the tunnel, just sometimes the tunnel seems soooo long! {hugs}
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I also didn't want to do a Lat as recommended by most PSs I saw. I found a great PS who was willing to listen to what I wanted and why. So, I had 2 rounds of FG (I didn't have enough fat for more than that) My PS wanted me to then do an expander but I opted to go direct to implant-the smallest one made. The FG made all of this possible. I am a big proponent of FG. I ended up with exactly what I wanted.
Madison, you can PM me with any questions you might have!
Babs
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