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Fat Grafting (transfer)- any post op advice?

zard
zard Member Posts: 3
edited January 2017 in Breast Reconstruction

Had my fat grafting (fat transfer) today.  They really gave me very little take home info, I was quite surprised.  

Had fat taken from my tummy to fill out the results of 2 lumpectomies and radiation 3 years ago.  The size difference between the 2 breasts have become quite noticeable (to me anyway!) and really controlled what tops I could wear.  

I'm wearing my compression garments- both tummy and bra (think the bra is just light compression- much more for support).  They have me meds- hydrocodone. But other that that not much advice.  Saw mixed info on line about heat and ice.  Should I massage either area at all, or is less touch better? Any advice would be great!

Comments

  • lane4
    lane4 Member Posts: 12
    edited April 2013

    Hi, zard, Congratulations on your fat grafting procedure! I really believe that is the best way to correct lumpectomy defects. I have had two sessions of fat grafting and my PS says not to massage the breast and don't wear anything that is very restrictive on the breast, in other words, don't wear a really tight bra for at least three weeks. I would guess that ice would not be a good idea on the breast, either, because you want the newly grafted fat to find a blood supply in order to survive. According to my PS, it takes about three weeks to establish a blood supply.

    However, you do want to wear your compression garment on the donor site. I was also instructed to massage the donor site beginning about five days post op.

    I hope all goes well with your recovery. Fat grafting is really a very easy procedure; the only bad part is the soreness and bruising from the liposuction. It does get better fast.

  • specialk
    specialk Member Posts: 9,262
    edited April 2013

    I had fat-grafting in December to fill upper poles above implants after BMX.  I have a bony chest and it was quite obvious that I had implants.  The surgery was very successful and I look natural now.  The donor sites for me were both hips, lower and upper abdomen.  The fat was injected through "stab" incisions in the cleavage - pointing upwards into the upper poles.  I was not to wear anything tight over the breasts, but definitely tight compression garments on the donor area.  I wore compression that went from just below the breasts down to the hip.  I was not given any massage instructions, but I was advised to wear compression for 8 weeks, and no exercise other than walking.  My plastic surgeon explained that the lipo cannula made tunnels into the donor sites and without long-term compression they can fill with fluid.  Wearing those garments for that long 24 hours a day was a PAIN, but so worth it because the area looks great.  I have been fortunate that almost none of the injected fat has re-absorbed.  We are waiting to see if I need a second procedure, but right now it does not appear so - I would totally do this surgery again in a heartbeat.  I had very little bruising, and far less discomfort than I anticipated.

  • SimplyAudrey
    SimplyAudrey Member Posts: 92
    edited April 2013

    Just had fat grafting on April 1st!  I had the same upper pole issue....BUT donor fat was slim pickings.  Inner thighs and belly below belly button.  Compression garments a must on the donor areas (spanx work fine or any garment similar for me)...and I got the "if you don't have to, don't worry about a bra" instructions.

    I would do it again in a heartbeat for the results we got, but anyone who does lipo for the fun of it has to be a masochist.......  Tongue Out

  • Carolanne03
    Carolanne03 Member Posts: 8
    edited April 2013

    I'm scheduled for fat grafting/ lipo revisions on the 23rd. I will not consult w/ ps until day of due to a schedule change. Not sure where the fat will be taken from but I'm happy to donate and hopeful that it'll create a more natural look. Oddly, I've started to get some feeling back in the nipples. Not sure if the nxt surgery will disturb that.. I ll keep you all posted!!

  • zard
    zard Member Posts: 3
    edited April 2013

    Thanks for the replies ladies, they've been very helpful!  (way more helpful than my PS's office!- I called and the receptionist RELAYED my question to the nurse- and wrong info back to me! Didn't even put me through to the nurse, much less the doctor!).  

    The swelling and pain has reduced to a doable level.  I did have some very nasty pooling of blood through my bikini area- DARK purple! So I've started warm compresses and massage and it seems to be improving.  Going for my FU on Monday.  See how that goes with my PS!

  • mrenee68
    mrenee68 Member Posts: 48
    edited April 2013

    Ok ladies I will be having revision surgery on the 8th of May and my PS said he will do some fat grafting to create a more natural slope, I have a really bad hollow spot. How painful is the fat grafting and what about the bruising. I'm starting to feel a little unsure about this.

  • zard
    zard Member Posts: 3
    edited April 2013

    @mrenee68... It has DEFINITELY been worth it! I had a bad hollow spot after 2 lumpectomies and rad 3 yrs ago.  I believe the difference between the breasts was becoming greater- esp w/ my weight gain on tamoxifen.  I was SO impressed at the first sight of the breast when I took off the bandages! My PS really worked to smooth out the scar and break up the hardened scar tissue.  It looks amazing! Yes there's still a scar, but not nearly so noticeable.  And the shape and size of the breast looks great so far.  

    My only disappointment was that there wasn't more lipo done.  But on my FU appt yesterday, he finally really explained that filling the breast was the main point of the procedure and full lipo would have been another 2 hours.  I wish he spent more time explaining things before surgery- so definitely make sure all your questions are satisfactorily answered.  

    Lastly, the pain and bruising... the first couple days were uncomfortable- mostly getting up in the morning and after sitting for a while.  Pain was mostly in the donor site (my tummy).  The compression garment (I have a wrap) is a little annoying, but doable.  I had hydrocodone for the pain. Bruising was ugly, but disappeared quickly.  Worst was actually pooling of blood in my bikini area- horrible dark purple after a few days.  I think the compression garment was forcing blood there below it.  Heat and massage broke it up.   Definitely plan on having several days off  from work.  I had surgery on Mon, and worked my pt retail job on Fri nite, and even that was tough.  So just plan on being able to take it easy for a good week, then easing back into things after that.  

  • specialk
    specialk Member Posts: 9,262
    edited April 2013

    It is important to understand that this surgery is coded as a breast revision surgery, not a cosmetic lipo.  Your PS has to be careful not to take a lot more fat than is required for re-injection because your insurance company can deny payment for the surgery is they suspect more fat was taken than needed for correction.  Also, you will have swelling in the donor areas for quite some time - it can be up to a year.  It is difficult to tell how much fat is taken until that swelling dissipates.  I had this surgery in December and I am still seeing change to the donor area.

  • regenschirm
    regenschirm Member Posts: 8
    edited April 2013

    I had my revisions with fat grafting to contour my sGAP breast and sGAP donor site. The bruising down my hips and thighs is impressive. Still sore a week out but mostly exhausted. Breast area looks great. I have to say I was unprepared for the amount of pain I have had. I didn't have much help lined up this time around and wish I had planned for that. I ran a fever a couple of days out but the surgeon told me it can happen after lipo which can make you anemic. Fever resolved by day 4 post op.

  • mrenee68
    mrenee68 Member Posts: 48
    edited April 2013

    Thank you Zard, SpecialK, and regenschirm for the info. Still sounds a little scary but worth it in the end. I have a home daycare so it is nice to know that I may need some help for awhile. Swelling at the donor site for maybe up to a year so does not sound cool, but it is what it is. So as the saying goes "Embrace the Suck".

    Thanks again!

  • specialk
    specialk Member Posts: 9,262
    edited April 2013

    mrenee - the long-term swelling is not noticeable - the PS is the only one who really knows - I am 4 months post-procedure and I don't see it, everything looks really good, so don't let that worry you!

  • regenschirm
    regenschirm Member Posts: 8
    edited April 2013

    "Embrace the suck"  that is so funny.    I have to say that my silhouette is really nice and slender, even with swelling and bruising.  Today was a little better than yesterday energywise and I only took one aleve.   I am sore right now though which is reminding me it is time to go and get that pill.   I don't have to wear the surgical bra anymore but I am wearing a panty girdle.  It's pretty comfortable.  I will confess to sleeping in yoga pants that don't go up so high.  Don't know if it will make a different.  The lipo was mostly flank and thigh on me.  

    I was pretty excited going into it - knowing it could look better (and I was already happy with my flat butt-boob which looked nice in clothes so who cares, right?)    I don't have any regrets.   

    This last surgery did throw me for a loop in the sense that each t ime I have to work my way back from surgery it takes such focus and effort and drive.  I did it first after the bilateral mastectomy in January of 2012.   Then I did radiation and had to heal from that.   DIEP came in september but I only got one side so that led to the sGAP in  December.   In between was more healing, stretching, walking, dancing etc.   So I was feeling pretty good going into this.  And now I am back in recovery mode.  The good news is that this is the last one.  I will go for an office visit to do the nipples but I will probably wait until after summer and swim season. 

    Another piece of advice is do not DO NOT google the procedure.  I was so silly to watch a youtube clip of how the grafting is done.   Made me feel faint to think that that is what happened to me.  Just skip it.

  • Carolanne03
    Carolanne03 Member Posts: 8
    edited April 2013

    Regenschirm congrats on being done with you final big procedure ! If I may ask - how long we're you instructed to wear the post surgery garments/ girdle business??? Guessing it'll be my biggest complaint/ or maybe the drains! My revision/ far grafting is Tuesday

  • regenschirm
    regenschirm Member Posts: 8
    edited April 2013

    4 weeks in the girdle. I got one that is tolerable though by days end I am ready to throw the thing out the window.   The surgical bra was only for a week this time - it was liberating to get out of that thing.   I am much MUCH less bruised today (9 days post-op).  I see the surgeon on Monday.   The PA told me that I could get away with a bike short type of thing but the nurse told me to wear something that comes up to the bra line.  So I'm erring on the side of caution until I see Dr. Pisano.

  • mrenee68
    mrenee68 Member Posts: 48
    edited April 2013

    Carolanne good luck on Tuesday and keep us updated on how it goes. Tight and constricted is not my cup of tea, anything too tight makes me really anxious. Well I guess just one more hurdle alone my journey. This to shall pass.

    Have a good one!

  • Carolanne03
    Carolanne03 Member Posts: 8
    edited April 2013

    Thank gals/ mrenee68, I too cannot stand anything constricting.. Maybe ill shoot over to target for a bike short tomorrow . I will kelp you posted. Thank you for your well wishes!

  • Carolanne03
    Carolanne03 Member Posts: 8
    edited April 2013

    Hey gals had my revisions/fat grafting today. For day one, pretty surprised how much easier than last surg.. Swapped out the girls for a slightly bigger size, lipo fr back of hips. Lots of bruising there. Back to a surgical bra for 6 wks! We ll see!!

  • PamKou
    PamKou Member Posts: 5
    edited April 2013

    Had exchange surgery with mini fat grafting from my stomach one week ago. I was not given or told to wear compression garment for belly. Hmmmm. .. . . Posted elsewhere- my stomach is still incredibly sore one week out.

  • Carolanne03
    Carolanne03 Member Posts: 8
    edited April 2013

    Hi PamKou- I was not told to wear compression garment either. Only the nasty " straight jacket " bra. I'm gonna call today to confirm that.

  • PamKou
    PamKou Member Posts: 5
    edited April 2013

    I had surgical bra for 4 days. He took off at appointment and told me to wear underwire bra during the day and sports bra at night. Nothing on stomach. Hmmm....

  • Carolanne03
    Carolanne03 Member Posts: 8
    edited April 2013

    Hi ladies! Day 3 post op fat grafting. Called surgeons office wed to discussed compression pant and yes the discharge nurse was suppose to give that to me so I am glad I called. Pain not too bad today. Yesterday a slight set back w/ a migraine and nausea. They changed up meds for the nausea.

  • tisthyme
    tisthyme Member Posts: 22
    edited April 2013

    I have had 2 of 6 fat graftings for entire breast mound bilateral reconstruction and my PS strongly suggests to use a rolling pin to roll out the donor sites about 3x/day for 10 minutes each time, and to wear a compression garment (spanx) for 1 week for every decade of age. It is like putting sausage back in to the casing for the first week or so, but it does help  My first fat grafting was from my stomach in November and it has healed nicely.  My second fg was from inner and outer thighs in March and I am still healing but suspect it will heal up great too.  Healing vibes to all.

  • mkw1
    mkw1 Member Posts: 102
    edited May 2013

    Special K: How much swelling are you talking about? I just had my lipo of the abdominal area and fat grafting this morning and I feel swollen like a balloon in both the donor and the breast area. I even gained 8 lbs. in a few hours. I know the PS placed an abdominal binder and packing inside of it, but I can see that my chest looks too large and wide through the elastic band they placed over it. 

    Thanks in advance for the info.

  • geroNP23
    geroNP23 Member Posts: 5
    edited December 2014

    I got rid of the girdle thing and used my spanx! Omg....way more comfy and ez to wear under clothing.

  • landrews
    landrews Member Posts: 1
    edited May 2015

    Hi! Just found this thread. It went up after my fat transfer Mar. 3, 2014. I have looked and looked for more info on the swelling at my donor site, but had been unable to find anything until this thread popped up. Every time I do anything close to exercise, even walking regularly, my belly swells. I had to put on fat for the transfer and was used to being very, very active and fit. I have basically been sitting around since last March waiting for this issue to resolve. Every time I see my surgeon, he says give it time. In Feb. he said another six months. I haven't ridden my upper-level dressage horse (or any horse) since Feb. 2014. Even if I just get on to walk around, I swell up like I'm six months pregnant. Go walking, swell up. Ride the exercise bike for five minutes, swell up.

    The surgeon says my lymphatics need time to heal. He's never mentioned, nor have I read elsewhere about tunnels being created that fill with fluid like stated above in thread. I was specifically told not to wear compression garments except a tight shirt. If I wear one now,over a year later, do I stand any chance of resolving the 'tunneling' or is it too late? What other kind of doctor do I need to go see? How do I go about even finding any other information on this? About half the fat stayed as placed in my reconstructed breasts- there is still some dimpling and pockets, but I won't be doing any more revision after this frustrating experience. I was looking for info and not finding any, but also trying to be patient since I read in several places that donors sites could take a year to heal. Now I'm really, really worried that this is it. Help?

  • Lisamarie6864
    Lisamarie6864 Member Posts: 5
    edited May 2015

    Hi all,

    Yesterday I had fat grafting and nipple sharing procedure done ( unilateral mastectomy and reconstruction with lift and small implant on healthy side done earlier ) my doctor was able to get fat from my sides and upper(side boob area) and put it in upper pole . I have just a small amount of pain from donor site...not bad at all. I am glad I don't have to deal with abdominal pain. I have nipple cups protecting both nipple. Will know on Friday how nipples look

  • kfinnigan
    kfinnigan Member Posts: 490
    edited May 2015

    Had nipple reconstruction with skin graft and also fat grafting from inner thighs to upper pole on 5/4/15.

    Saw my plastic surgeon yesterday and got the unveiling! I still have a lot of healing to do he said and will get stitches removed from my breast and my skin graft donor site next week with the Plastic Surgery nurse . Then I see him again in 3 weeks. He did say the skin graft donor site looks like it's trying to open a little in one spot so I need to be careful with that.

    He sent me home with a swag bag of supplies that I need for my arts and crafts breast project haha, that's literally what he said.

    I can do more things with my right arm just be careful of the left side.

    He gave me a note to return to work on the 26th.

    He said fat grating feels soft and filled in nicely. He said it takes about two months to tell if it will fail, but he has faith it will stay put

  • Suz-Q
    Suz-Q Member Posts: 110
    edited January 2017

    I had fat grafting last August. It did not take as well as I would've liked it to. I had 180 cc's placed on each side. Now I've decided to go with small implants to correct the asymmetry that I have. The grafting took better on my noradiated breast than it did on my radiated breast. I really don't have enough fat left to do many more procedures. I was wondering can fat grafting be done at the same time implants are placed? I still need a little fat to correct the lumpectomy divot and soften the firm scar tissue as well as to further soften up my radiated breast. I don't think my plastic surgeon will place more than 100cc's.

  • SeattleBound
    SeattleBound Member Posts: 40
    edited January 2017

    Hi Everyone,

    I developed keloid scars following a biopsy (28yrs ago), my bilateral mastectomy, and less so with my TE to implant surgery 8/2016 due to excellent skills of my PS who did scar revision. Have any of you developed keloid scars at the fat donor site or where fat was injected in the breast areas?

    And,if your fat grafting PS is also very experienced in doing repair/pocket revision with the use of Alloderm and Strattice, please share his or her name! My capsular contraction seems to be rapidly worsening in spite of massage and Vitamin E and I need work on the other breast that has dropped and migrated. I will most likely have to travel to get with the right PS.

    Thank you!