Fat Grafting, pros and cons
Comments
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Thanks, Julie. I've got noticeable rippling and am planning on doing FG in February. My PS wants me to wait 6 months after exchange to let everything settle. It's disappointing to hear that most women need 2-3 sessions--that's another 2-3 weeks off work! Ugh.
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Does anyone know how many cc's were removed. My surgeon is saying about 80ccs. Does anyone know if that is alot? I am more nervous about the results on the donor site as I am pretty thin. Any input is greatly appreciated!!
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i had 1 litre removed from each site
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I had a little more than 300 cc 's taken.
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I had about 400 cc 's, 200 for each breast.
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80 cc's is hardly anything - just 5 tablespoons. You don't have to wear compression garments with that amount do you?
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Sandra,
On New Years Eve last year, I only had 40cc of fat taken off sides of my hip on an old scar and injected into one foob in 5 different openings in an elliptical shape in the cleavage side/upper pole....yup, wore compression for 2 weeks, panti-girdle type for two days for fat harvesting sites, and then a tube type much easier/less painful to get panties down to use the bathroom (most of the pain was from pulling up and down undies), as I was drinking lots of water. (nothing on the fat injected foob)
bandages were to protect my new nips.....which I now want to get removed, one flattened and the other is 2.5CM lower!
I was amazed that this (FG) is not just suck fat, then inject it....after I read my operative report....there is a lot to creating a path for the fat before my fat went back into my body
BTW.....I could not even find these poke marks 6 months post op.
Sandra....I am a post RNY 2001, and side to side and up the middle abdominal "reconstruction" 2002<----this is why I did not have TE put in at the time of BMX due to a post operative infection 10 years ago on another part of my body!!! my PS said NO!!!
I begged to have fat taken out of my upper arms or my inner thighs as I have lots of excess.
Di
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I had BMX w TE placed in May. Lost right te due to infection in June. Waiting six month (January) to proceed with reconstruction. Left te kept flipping and causing me a lot of discomfort, so went ahead with exchange on my left 10/31. I have a pretty significant amount of fat left on my right side. PS suggested fat grafting instead of te/exchange. Honestly, there's not much difference in the size, but my right breast is just like a deflated balloon. My left is a mentor 600. Has anyone ever heard of this being done? Have about a month to decide. She feels that we would probably need two surgeries of grafting, also two if I choose expander/exchange.
Would appreciate any thoughts you wonderful ladies might have.
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Sandra - my PS prescribes 8 weeks of compression, no gym, walking only and lifting restriction for 8 weeks regardless of the amount of fat removed. This is for the prevention of a seroma at the donor site, and to keep the cannula tunnels from filling with fluid. I just had FG done last week, a very small amount across the front of my chest to improve the condition of the skin prior to attempting another TE on that side. I will FG at least once more, maybe twice. I had aesthetic FG done at the upper poles a couple of years ago, a year after my original exchange, and the compression rules are the same for both.
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Thanks so much. I'm glad to hear from "the experts" who've already had this done. Obviously I don't know much yet so I'm getting my questions ready for the plastic surgeon when I see him in about two weeks. Hopefully he will say I am recovered enough from the October 3rd surgery #5 to set a date for surgery #6 for fat grafting. He put in AlloDerm and reworked the pockets so that implants sit much higher than before. They had bottomed out for the second time - fallen about an inch below the IMF in spite of another row of stitches put in on surgery #4 that was supposed to correct the problem. The AlloDerm appears to be working and I have a little bit of ptosis now...something I've never had before.
Because the implants are up where they belong again, they are doing the job they were put in for when I switched from rounds to 410's. The tall implants cover up a lot of the divots on my chest. Still there are many big low spots that the PS said would respond well to fat grafting. You can see the places in the photo - dark areas are not bruises...they are hollows.
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Sandra - I had the same situation after the first exchange - FG was fantastic for fixing that issue! Created a very natural looking and soft upper pole - one of the best experiences I had on the scenic reconstruction route I have taken, lol!
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sandra4611. Did I understand you to say they didn't put your Alloderm in at the time of the intitial surgery?
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Angelica, yes this is my first time with AlloDerm. I got my first implants at the same time as my BMX. Due to a hospital acquired infection, I've had 4 more surgeries. This last one seems to have finally conquered the damaged muscle demons that were pushing and pulling my implants out of place. My PS said if this didn't work, we'd have to remove the implants and do Lat Flaps because my paper-thin skin couldn't tolerate another attempt. I'm seven weeks out and so far so good. The combination of a reconfigured pocket and AlloDerm seems to be working. My own tissue has to grow into the AlloDerm so the PS has remained cautiously optimistic that this will be a permanent fix. He's had me in support bras 24/7 (never had to wear them before) and restricted activity. Hopefully when I see him on Dec. 4 (my birthday!) he'll be pleased enough to schedule the fat grafting/mudflap removal.
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sandra, I hope so too. I read on here and it really scares me. I am due to have exchange in Dec and I dread another surgery. I am a uni so he wants to do a lift on the natural side and I worry about messing with that side and running the possibility of something going wrong over there. It is scary too about how many infections people got while in the hospital. Did they start you on antibiotics at the time of all your surgeries?
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Yes, I was on an antibiotic before surgery even started. The infections was "acquired" in the OR and its effects were first noticed as a fever a couple of hours after I got to my room. Stronger antibiotics were tried over the next 3 days, but nothing slowed down the resistant gram-positive staph until they tried Vancomycin. I lost skin, parts of 3 muscles and soft tissue on my left side below the axilla, the front of my left shoulder, and about 1/3rd the way up the side of the left implant. I've had surgery to repair muscles and give me some range of motion in my shoulder and several others to try to convince my altered anatomy to accept an implant and leave it where it belongs. My left side in a combination of skin over bone due to the loss of soft tissue padding underneath and an overgrown mudflap due to additional surgery. Why couldn't the infection have taken that soft tissue too?
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sandra, bless your heart. That is terrible. Just the surgery is bad enough without having to deal with something so unforseen. I hope you have smooth sailing from here on out.
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Thanks Angelia. It was supposed to be a "one and done" surgery. (sigh) Looking on the bright side, I didn't have to have rads or chemo, so I feel lucky.
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sandra, I totally understand that. I didnt' have to have those either and I feel blessed but sometimes, I feel afraid that maybe I should have had the chemo. But, mine was 100% ER positive and like %85 progesterone and my doctor said I get a bigger bang for my buck with the arimidex. It is such a scary idea that there are cells just waiting to take hold but I am trying so hard to move that to the back of my head.
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My surgeon did not mention I would need to wear compression garments with the 80ccs - I am pretty thin and not much fat on abdomen - they are going to try my inner thighs - 80ccs.
I am wondering if I should insist on compression garments? I thought I was done with making decisions but it is never ending. Now if I could just decide small c cup or full c cup - . Surgery is tomorrow. Anyone have experience with small amount of fat grafted from inner thighs? Did it help a lot with the radiated breast. My doc thinks it will be better for the implant on the radiated side.
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You can just wear your own compression - Spanx shorts will handle your inner thighs. I had a very small amount done this last time, as this will be a phased approach, and my PS insists that I wear the compression regardless of the amount of fat taken. You might PM babs6287 - she did fat grafting to help radiated skin, but I believe that she did it prior to recon. I am not sure if it would help if it is done at the time of exchange - usually fat grafting done then is mainly for aesthetics, either removing fat from an area that needs smoothing, or adding it to add fullness. Fat grafting for previously radiated skin is usually done in advance to assist with vascularity and to add some thickness.
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I had fat grafting done for the first time at time of exchange. Not usually done that way from what I read here, but my PS is progressive and thought it would be fine. Did much to heal my rads side. Had the grafting a second time to work on the "ledge" above my implants. Both rounds a success. Both rounds healed and improved rads side.
(Should mention that I had TE prior to rads starting.)0 -
bayou - so glad that the grafting improved your post-rads skin at the time of exchange - that is encouraging!
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Bayoubabe, my doctor never mentioned fat grafting at all to me until the fills were done and he discussed the exchange. I had commented at one point that it seemed as if the expander was going way over under my arm and he had said he would fix all of that and would suck that all out and on the opposite side as well. Then at the last exam, he did say he planed to do some grafting likely with what was removed form that under arm area, so, he is doing mine at time of exchange or thats what I think is the plan. I have to admit, we didn't discuss what kind in detail. I did ask and he said maybe this or maybe that and he would take two sizes in the OR and determine which at that time. I see lots of ladies on here seem to ask for one kind or the other but I sure don't know what is best for me and I figure he's seen way more than me, so I'll hope he knows what he's doing and gives me a good result.
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angelia50 - if you haven't already done so, be sure to find the thread titled "Breast Implant Sizing 101" and also be sure to pm member "Whippetmom" for help. She is our implant guru here and knows her stuff better than some of the PS!!
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Hi ladies.....so I am hoping to have some fat grafting on 12/23(I'm post double nipple-sparing mastectomy in 4/2013 stage 0/DCIS intermediate grade right breast 0/2 lymph nodes)....this is the 3rd time I have tried to schedule (insurance is giving me the run-around)...anyway, I really wanted to have fat grafting done with my belly fat, but my PS said he prefers not to go there as it leaves a lot of loose skin afterwards. So? Fix that too? I was a little surprised by this. While I am not super skinny, I am not in plus sizes either. He prefers to take from my "love handles" or inner thighs. I prefer not to go there. Anyone have any experiences with which harvest site is "better"? and while I know that everyone's case would be a little different-just wanting to hear what others have experience with selecting their donor site, particularly the abdomen. I lose weight everywhere except my abdomen-I really wanted it taken from there.
Thoughts? Huge thanks in advance......
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My PS said she could take it from anywhere such as my stomach or thighs. I'm thinking I want outer thighs. I am waiting to be scheduled but it might not be until February because she is so booked.
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I have had fat grafting with the donor site as the abdomen twice - for different reasons. My initial fat graft was to fill out the upper poles and a larger quantity of fat was taken, and a little bit was also taken from each hip. I had no issues with loose skin, but this would vary from person to person. My PS doesn't like to take from thighs because, in his experience, you are more likely to have issues at the donor site. It is important to note that in order for this type of fat grafting to be covered by insurance your PS can only harvest as much fat as is necessary to correct the breast defect - which is often not very much. Most people do not see a large difference at the donor site in terms of fat reduction.
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OMG! It's the beautiful Julie! Hi Julie!
My PS did abdomen and flanks first. Then he did some strange area I don't understand, but it involved my butt (OMG, my whole backside was black). Now he is going to do inner thighs. I think the skin on inner thighs would have a tendency not to snap back also. But I am nearly out of options. Wish he would do my fat upper arms!0 -
Hi Special K! Posting at same time! Guess what I am doing? (HINT: SaTC)0
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bobo - Hi!!! Yay for satc!
Julie - hi to you too!
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