Fat Grafting, pros and cons
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I had my second fat graft about four months ago, taken from my outer thighs - lots of bruising and pain, in fact they are still a bit tender in places. I told my PS when I went for the post checkup that it felt like I'd been kicked by a horse and he said he gets a lot of women telling him it's painful from the legs. Well duh! I asked why it's more painful from that donor site and he said because he is scraping across the muscles. Makes sense I suppose.
There is definitely a lot of variation in instructions afterwards, I didn't wear a bra for a couple of weeks so as to not put any pressure on the foob and wore spanx type pants for the bruised legs.
I apologize in advance if this is TMI but I got my period the day after my nine hour surgery where I was flat on my back,had four drains, a catheter and was unable to wear any knickers!
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Hi Suzyblue! Did you retain all your grafted fat? Do u feel that it was worth it?
I guess I will take it easy as long as I can before I have to return to work (2 weeks).
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Suzy--that sounds terrible! What did you do about your period?
My PS was concerned that he couldn't get enough fat off me--I kept having to show off my pudgy thighs to prove I had some! I think he also doesn't like the unpredictability of FG. I'm sure he didn't want to promise that it would work and then have me disappointed. When I told him I didn't like the rippling, he said I could either switch implants and put in aloderm between the implants and the skin or try FG. I think he liked the predictability of the former surgery, but he agreed that FG was a pretty low-risk solution. Replacing implants always has that infection risk.
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Elizabethaw, did the fat graft help the rippling so far? My problems are, pulled in incision line on left, right bottom is flatter than the left, slight rippling on the right, and sunken in on top of left implant. My ps is confident that FG will help, but it may take a few rounds. How bad was your pain level after? How quick was your recovery?
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Hi Kingster and Elizabeth, I think I have retained most of the fat this time, my PS said it can take a few months to know for sure. I got a bit of fat necrosis both times but massage broke the lumps down pretty quickly. I'm happy with the results as they stand at the moment but whatever happens I'm not going to put myself through it for a third time. Like you Elizabeth, I didn't seem to have as much usable fat as I was quite sure I had lol, so I'm not sure if the PS could do it again anyway.
As far as my period problem goes, the nurse gave me a giant incontinance type pad to wedge between my legs. It's lucky that I was feeling pretty out of it and had left modesty behind some time prior
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Suzyblue, where was your fat necrosis at? Chest or donor site? I had fat necrosis after my bmx, but the lumps on the sides have improved with time and massage.
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Hey Kingster, I had my FG exactly one week ago today and am back to work with no problems. I feel a bit bruised, my chest is sore if I bump it, and the compression garment is tight around my middle. Otherwise, I'm completely fine. The pain was not a major issue.
My PS felt that all of my issues were solved--but as I said before, I'm afraid to really look because I don't want to get attached to it if I don't get to keep it! He (PS) felt that even if I reabsorb a lot of it, the problems will stay fixed. I suspect things are great now--I did see the weird rib bump that was showing in the cleavage is beautifully covered now--but I'm afraid it won't last!
If I get to keep the fat where it is, it will have been totally worth it!
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Kingster, the necrosis was in the foob both times, but went away, as you say, with time and massage. I don't think it has had a big impact on fat retention this time, though the first time I did end up a bit 'empty' on one side, hence the second attempt. Fingers crossed!
Elizabeth, very glad to hear you are back up and running so quickly. I'm sending happy thoughts to your new fat deposits to stay where they have been put lol! There really doesn't seem to be a 'norm' when it comes to this procedure and how each individual copes or reacts, so my advice to anyone about to undergo grafting is just to take it as it comes and do what you feel Is right for you in terms of recovery
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Thanks guys! Elizabeth, very encouraging and hope you get to keep all your fat graft and have wonderful soft results;)
Thanks Suzyblue.
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Just past my exchange surgery and fat grafting, yesterday. I know it's all swollen but the fat grafting looks pretty good. Hard to tell what everything will look like in a few weeks. I am sore where they took the fat from my abdomen but this ain't nothing compared to a mastectomy!
I too get confusing and incomplete info from my PS office. I guess compression is the thing and I'm supposed to wear a sports bra for 6 weeks. In my next life I am going to be a patient communications specialist!
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I hear you on that, Rebecca54! I have mentioned the super-lame discharge instructions I get each time, and the response is always, "oh yes, we are working on that." Thank goodness for this forum!
Also, the impression I have for fat grafting is compression on the donor site and as little compression (and movement) of the donor site as possible. Lots of women here were told no bra. I have a super-loose surgical bra/vest thing, but I might ditch it. My PS seemed most concerned about movement. He said, "No running and no jumping." My husband said, "So no trampolines?" I said, "No Pilates or yoga?" PS said, "oh no, no." My discharge instructions say no underwire bras for two weeks and to wear the little surgical vest thing for 2-3 weeks (depending on what part of the instructions you believe). Then again, my discharge instructions are also for breast reduction, so...
Glad you're doing well!
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E - what no trampolines? That made me laugh!
Rebecca - sports bra on top of your graft? I would question that. If your graft is above it - probably ok
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I know! Smart-ass husband.
I found this text in an article in the 'Indian Journal of Plastic Surgery,' and I thought it was super-useful. Maybe it will be helpful for someone else out there.
"Swelling or oedema is anticipated after almost every liposuction procedure as a normal reaction of the human tissues to the actual surgical trauma of the cannula similar to the response of sterile inflammation that occurs after any trauma. This is usually controlled by the immediate use of a compression garment for a period of 4-6 weeks. This swelling will be apparent within 24-48 h after the procedure and continues to mildly increase for the first 10-14 days. It is soft and mildly tender without any significant signs of inflammation. Thereafter, as the remnants of the infiltrated fluid, serum and broken down fat are absorbed by the body, the swelling changes to a more firm to woody consistency with no or minimal pain and discomfort by the end of 2-3 weeks. By the end of 4 weeks, parts of the operated swollen areas start to soften in patches until the entire area shows a consistent softening by the end of 6-8 weeks. Depending on the extensiveness of the operated area, the tissues tend to return to a normal pliant feel by 3 months after the procedure. Rarely, brawny post-operative oedema with unusual pain and discomfort persists beyond 6 weeks and according to Shiffman this may be due to excessive trauma to the tissues leading to an internal burn-like injury. This will then take a longer time to settle and may result in increased scarring, fibrosis and often surface contour irregularities."
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E - your DH sounds like my kind of person, lol! My PS has also said that the donor site doesn't take its true form for about six months. There can be slow bruise resolution and remaining swelling up until that time, but my anecdotal experience indicates compression at the donor sites helps, both with swelling and support - I have been more comfortable with it than without it
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I am 3 days post op revision and fat grafting....I had some derma matrix added in areas where my tissue was very thin. I think he grafted fat in these thin areas also. I am having pain where the tissues seems to be very tight. Has anyone else experienced this? I don't see the PS until Tuesday next week and won't have any details until then.
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Hi Ladies,
I am going in next Thursday for fat grafting and nipple recon. I have so many questions but I'll start with the first question
1. My silicone implants are always freezing cold, which causes pain, will fat grafting fix/help this ?
2. crap, I cant remember the rest of my questions lol, THANKS arimidex !
Advice on nipples ? Any one have them reconstructed or did you get 3D tats ? Experiences and advice is so appreciated
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jnccobb, I'm 9 days out from FG, and I still have lingering feelings of tightness, and I was surprised that I have bruises on both breasts. Not the purple kind I have from the lipo, but broad yellow areas. I'm not feeling pain--just fullness or tightness, but I didn't have any pocket work or such. What kind of pain do you have?
Hi ganzgirl, I don't know if FG will help the coldness, but I would be thrilled if it improved mine! I'm sure it depends on exactly where the fat is placed, how much fat is used, and a whole lot of luck! Some people seem to get improvements in coldness, but I think it's quite unpredictable.
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Elizabethaw, The pain was just real tightness and pressure on one side only. This is also the side where my tissue is very thin and limited the size of my implant 😔. The pain much better today so maybe I had an unreasonable expectation or just forgot about the pain part since I had a pretty significant break since last surgery. I also have bruises that are yellow. I don't see PS til Tuesday....anxious to hear what he thinks. Of course to me they still look awful but I am sure a lot of its swelling and will take time to settle.
Ganzgirl, I also have silicone implants and they also hurt when they are cold.
Does anyone else have times when their breast/implants just ache? I have found prior to surgery that I had days where my breast would just hurt and ache.....kinda like people who have had broken bones and such....does anyone else experience this
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Re Fat Grafting: Does anyone have a donor site that looks like the Dr took more from one side than the other? The hole is in my right side of my abdomen. It looks like a larger area was taken from there, and that she got less and less as she went across. It was 5 weeks ago, so thought it should look more normal by now.
Re Nipple Reconstruction: I just ordered and received temporary 3D nipple tattoos from www.nippletattoos.com to try them out in a couple of different "shades" and see what they look like before making a final decision on nipple reconstruction. I spoke with the tattoo artist here in Calgary - she also trains others to do this. She will do the tattoos even if you have small nubs from a reconstruction. Take a look at her website and you will find quite a bit of information.
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Coldness depends on the amount of fat covering your implants. One of mine is cold and the other isn't because I have much more fat on one side. The fat on the other was lost in the bad infection I had. A tissue expander helped me grow new skin to cover an implant but not new fat under it. I don't see rippling on the "warm" side but do on the "cold" side, especially if I'm leaning over or reaching up.
Since I have no feeling in my chest, I don't notice when my foobs are cool or the left one is downright cold unless my arm brushes across it. I wouldn't look for fat grafting to help much with coldness since most of us have the fat placed above our implants in what's called the upper pole. That covers up the "step off" that some of us have after implants are placed and creates a more natural slope. To put tiny bits of fat all over and around an implant would take forever. It's not like you can just "squirt" it in a couple of places and have it move around until it is evenly distributed. It needs to be carefully layered to insure it will find a blood supply and not die. That's why we are told to not compress the chest and eliminate excess movement. My PS in Texas gave me the same instructions as SpecialK.
As to pain, I'm sure it has a lot to do with the skill of the surgeon in removing the fat during the lipo portion as well as how much area they had to damage to do it. If you've never seen it, it's a very brutal procedure. No wonder it's so darn painful afterwards. All the soft tissue and muscles in my abdomen felt like they'd been kicked by a horse. But remember, I had a quart of fat grafted, not 100cc's (6 tablespoons) like some people do, so much more of my body was affected by the lipo process. Ask your doctor how much he/she thinks will be "harvested". Your pain level will probably correspond to that as well as the time you will be off work. Also, some people take pain drugs afterwards so that decreases their pain. I'm allergic so I only take plain Tylenol.
I had no bruising but the donor areas all over my abdomen hurt like the dickens for the first week when I had to stand up. Sitting was fine. The second week was better but it hurt for several weeks. A compression garment is essential in my opinion. You feel so much better with it on. I wore a hospital grade "wrap around" compression binder with velcro closures that went from upper abdomen to my hips. The bottom was open so if you buy one of those there is no issue with bathroom essentials. You can buy one on Amazon and they are cheap, depending on the size, but SO worth it. They come in lots of sizes so you don't have to wear something too long or uncomfortable. I wore jeans over it with no problem. Mine was made by Dale and had a specific combo of compression in several strengths to provide the most across my abdomen and less at the top and bottom. It had openings for drains, in case you have them, and a separate velcro band to hold the drains. Just checked...Amazon has them from $15 on up to about $50, depending on the size and width. Here's a link to one.
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I had my fat grafting surgery yesterday. All went well. Surgery started around 9 am and was home at 1:15 or so. Feels like I did about 4 Pilates classes in a row, and a bunch of push ups. Chest is itchy today. The upper breast areas hurt the most right after, but now the abdomen hurts more. Some bruising but not too bad so far. It's amazing what can be done these days:)
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Hey Kingster! I'm glad you're doing well. I'm sending you keep-put fat wishes!
I'm a Pilates fan too--how long did your PS say to wait before you go back?
How much fat did your PS take?
Best wishes to you!!
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Hi Elizabethaw, my doc told me that recovery would be fast. I took 2 weeks just in case. I guess I could always go back earlier. My PS said that he put 165 ml each side. When he called me this AM to follow up, he said that he didn't want to put too much in, because fat needs to find a blood supply and not be crowded. I'm more sore tonight though. My chest is so itchy. I am allowed to shower Monday. I am in a surgibra and dressings. Gonna try to go to church tomorrow;)
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Has anyone found that fat grafting is harder to recover from than the exchange? All I want to do is sleep. I am taking very little pain meds, but can't seem to stay awake. The bruising is rather extensive and frightening. Also, my upper chest is quite sore, and it hurts when I use my arms. I'm only 3 days out, but this surgery is not for sissies!
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I had about a year between exchange and fat grafting, so it's hard to remember exactly. With both surgeries the biggest impact was the anesthesia. I felt really sleepy and worn out for at least a week with both. I didn't find the pain to be too bad with either one. (The BMX on the other hand...) I was back at work after one week for both--but I have a sitting-down office job and I only work part-time.
I did find with the FG that I was really uncomfortable when I moved for about 3-4 days, and then one day I really noticed an improvement in pain. I am at 20 days out now (surgery on the 30th of Sept--easy to keep track of how long it's been!), and the bruising is almost gone on the donor sites. The donor sites are sore if I put a lot of pressure on them, but I hardly notice them in day-to-day life. Sometimes I do get a sort of stinging or burning, but it's not long lasting. It had not occurred to me that my chest would be sore. I suppose I didn't think enough fat would be transferred there to make a difference, but I definitely felt sore there. I'm still a little tender there, but mostly I'm trying really hard not to put any pressure on the fat grafted areas. I've got one incision spot on each breast and about 10 more scattered across my donor sites. They've all closed up and look no worse than bad mosquito bites.
For reference, my PS said he was able to take about half a liter of fat from a bunch of donor sites (belly, flank and inner and outer thighs). I only bruised on the flank area, which apparently contributed the most fat. He didn't think he'd be able to get enough fat, so he took as much as he could from those sites. I'm not sure how much ended up being transferred to each breast, but he said he ended up with more than he needed.
I'm seeing my PS on Thursday, and I've got tons of questions about how and when to transition into doing things normally! I've been trying so hard to be still and eat a lot! Now I'm really itching to more around and do more, but I'm so afraid of ruining my results. I still haven't looked in a mirror! (Well, I've looked at the donor sites, but not the breasts...) I can tell that everything I wanted fixed was fixed--based on just looking down during showers--but I still am afraid all the fat will fade away and the problems will come back. Fingers crossed!!
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Also, I did have a few days where the incisions were super itchy! Showering is an awesome thing. Fortunately the itchies didn't last too long for me--I suspect because the incisions are very small with a single stitch.
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Just saw my PS at 3 weeks post surgery. He was very happy with the results--I think he high-fived me three times! As I've said before, I'm afraid to look for fear they'll be perfect but gradually fade away as the fat is reabsorbed. He said that he overfilled in the assumption that some fat will be reabsorbed, so we're hoping enough stays to fix the rippling and other assorted issues. We had initially decided I wouldn't run or do any form of exercise (other than walking, and I'm not doing much of that right now either) until after three weeks. He suggested that I hold off a little longer because he doesn't want anything to risk the results. We decided that I'd do gentle yoga and Pilates, carefully avoiding anything that put any strain or pressure on my chest, but no cardio-type things. I've been eating pretty indulgently too--more fats and never getting too hungry. He confirmed that there just isn't any good information about what determines how much of the fat stays (with the exception of surgical technique/harvesting/etc.), so we just have to hope.
Funny moment: PS had given the FG a 50/50% chance of success in getting rid of the ripples. I asked today if he was concerned about being able to harvest enough fat or about it being reabsorbed. He said he was mostly concerned about getting enough fat. "You were right," he said, "You did have enough fat!.....um...no offense or anything..." Reconstruction is a weird journey!
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Elizabeth, good to hear! So how long for no cardio? I had my 1 week follow up today. He suggested repeating a second fat graft in 3 months. I can't bring myself to even consider that right now as sore as I am. My ps did not want to overfill because he said the fat has a better chance of survival if it's not too crowded. It's difficult to know what to believe anymore. He just told me to massage my abdomen to keep it soft. No exercise limits were given. I'm so confused right now.
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Elizabeth -great to hear everything is looking good n will keep my fingers crossed for u that u have the obedient fat that want to stays put
Kingster - my PS is same as yours so don't fret about another FG session just yet. While I was disappointed at first to hear she didn't use a lot this time , I was more comforted when she explained the reasoning of staggering the fat to aid in blood supply n also to not get fat necrosis. I'm almost 2 months post op n am thrilled that i Don't have rippling medially anymore. Still have some in upper pole in one when I bend over but u can't see it in a bra so am undecided as yet as to another FG session although the FG recovery wasnt as horrible as some of the posts I read. I certainly wouldn't hesitate.to do it again if needed but that's not even on my radar at this point. After a year and a half of trying to construct boobies I finally have a matching set. It did take 6 consults but it was all worth it because It really is amazing what a great PS can do.
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