Fat Grafting, pros and cons
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My PS said I would see a small difference. I hope so! She said that it might take 2 sessions and that she could do more fat during the second session compared to the first. She said the fat is more likely to stay the second time because it is injected into the fat from the first time. I kind of hope I don't need to do it twice, though.
Hi Bobo and SpecialK
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My inner thighs are the area that has not sprung back so well.........abdomen was ok but I have a roll or so that was previously part of a larger whole of fat...!
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Thanks for the responses. In order to retrieve good viable fat, I was told they often will take more than required as not all the fat cells survive. I'm just trying to figure out why he is so hesitant to do the abdominal area. I guess we'll see what happens......Thanks again!
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Gero, my PS said he wouldn't use my abdomen because of "stem to stern" scaring from two previous abdominal surgeries. However I know of others (SpecialK being one) who had previous abdominal surgeries and it didn't matter to the PS.
I see the PS on Thursday this week and hope he will say I'm recovered enough from surgery #5 to schedule #6 for fat grafting. He wanted all the swelling to go down so he could have an accurate picture of where the fat needs to go. Again, others have said their PS did not have that opinion. So apparently this is like every single step in this journey...no clear right or wrong answer from PS's.
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To clarify - most of my abdominal surgeries, with the exception of a laparoscopic reflux surgery with scattered port sites, have been low "bikini line" incisions, so I wonder if that makes a difference. Interestingly, my PS uses the tail end of those long incisions for the cannula entry points so that I don't have any new scars. He also used one of the scattered port sites from the reflux surgery that is just above my belly button. My PS is also one who does not do fat grafting at exchange - my aesthetic one was done a year after exchange. My most recent fat grafting, two weeks ago, used the exact same low abdominal donor site, but was for injecting fat into the flat side to try to aid the thin skin with increased vascularity and to help it thicken in order to receive another TE. Some PS are now doing this for radiated skin to prepare it for expansion - same concept, although I did not have rads, just a lot of skin issues. Like, really a lot, lol!
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Hi - I had 3 rounds of fat grafting for a UMX with alloderm and implant. I had previously had a C-section, which didn't seem to phase my PS at all. I also have skin issues, very thin on the MX side and my PS was very worried about the lipo because I didn't have a lot of fat to donate. But he did a great job, one small incision right inside my belly button that you cant see, and the flank and outer thigh incision scars have faded and I couldn't tell you where they are anymore. The addition of the fat to my implant was amazingly helpful, both visually and in the way it feels. It's a little lumpy if you really feel around, but mostly feels like real tissue (and that's wonderful!) Recovery was not too bad. Worst part for me was wearing the horrible compression garment. Hated those things!!! But PS said if you don't, you'll end up with bulges or divots. Had to stay away from the gym for 2+ weeks and it made me grumpy. But really, after those 2 weeks I felt great.
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I did fat grafting the last week of September to rebuild the area I lost from the necrosis problem from the second flap surgery. About 60% remained. It was harvested from my upper abdomen. I wore no compression at all and I walked the Komen 5K 6 days following the surgery with my PS's blessing. I had no complications or lumpy areas. I am scheduled to do more fat grafting and remove my left hip next Monday. Hoping this will be my last one for symmetry. It is so good to see an end to this process.
For those who remember me, I also found out yesterday all my hand problems are definitely carpel tunnel and I have reached the end of that road. I will be doing surgery for my right wrist Dec 19 and my left wrist Dec 29.
So good to hear so many of us are now making progress. Hang in there ladies and let's hope everyone keeps moving to the end goal with no more problems.
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That was great info Julie, thank you. I did a lot of research on FG and the positive outcomes with healing, etc. While I have not had it done, I am a strong supporter based on all that I have read. Can't wait to read how it all goes for you.
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Well, I got good news yesterday. The PS feels that my October surgery #5 was a success and I'm ready for the fat grafting surgery. He didn't want to do it until he was sure no more surgery was needed. Even better, instead of waiting a couple of months, he said he could do it on December 19th. I'm delighted. Previously he had said he didn't want to take the fat from my abdomen because of several previous big surgeries (gall bladder, open RNY, lower body lift, and abdominal hysterectomy) that left scars from my sternum all the way down and across. Apparently he was impressed with all the ab fat I've grown during the last year of eating cookies and doesn't want it to go to waste.
He says he wants a CT scan to make sure there are no abdominal hernias or other surprises that could cause a problem during fat retrieval, but assuming it turns out fine, he will take the ab fat after all. Apparently it's much easier to recover from lipo to the upper abdomen rather than the thighs. I will be in a Velcro closure binder for a while, but that's ok. At least I won't have to deal with trying to get Spanx-like garments up and down over painful thighs. What kind of restrictions did all of you have afterwards? I asked if I would be able to snorkel and dive on a vacation to Belize in February and he said, "sure."
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sandra - I also woke up in a Velcro binder (with a foam layer) but found that because I am short-waisted that it kept riding up and the Velcro was chafing the underside of my implant(s). I did better with a Spanx (or other manufacturer) high waist panty with a snap crotch - that last part is very important!!! That way I put the panty on, and could just unsnap it whenever I needed - more comfortable under clothes than the binder. I was also instructed not to compress the part that had accepted the graft, so the panty works well as opposed to a full body type garment. Ask your PS if this type of thing is ok with him. On restrictions - my PS has me wear the compression 24/7 for 8 weeks, which is a bit longer than most, and I can only walk, can't go to the gym or do exercise that engages the core.
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Going in for FG on Thursday. Gosh, I'm so nervous and afraid. After MX experience I'm not looking forward to another surgery. I'm planning on going back to work on that Monday. Is it possible? So much to do at work and prep for the holidays at home! Any thing I need to know that will help recovery process that maybe doctor doesn't tell you.
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I just had my second fat grafting yesterday afternoon and I am moving good. I did have to take a pain pill each 6 hours so far. The most painful area is the donor site. The breasts feel good. I am in compression from the knees to the upper chest this time.
I had my first fat grafting on Monday morning then 5 days later, I walked the Komen 5K walk that Saturday. And could have probably walked a while longer. This procedure he did not put me in compression.
The problem you may run into is if you are still on meds driving is a no-no.
Having the procedure on Thursday gives you 4 days of rest. I would have been able to go to work on Monday.
I do think the compression helps as far as muscle soreness and tension on the donor sites. Holds everything really still.
I don't know of anything special to do except drink plenty of water, protein, and walking. Keep the arms down, limit the amount you lift, and walk.
Good luck. Keep us updated.
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Jbdayton, thanks for the info on post op restrictions. My donor site will be my upper abdomen and I know I will have a compression binder around it for a couple of weeks. The PS didn't say anything about compression of my chest so I guess that won't happen. Are there pros and cons? I assume I will have a hard time getting up and down because of the lipo but should be able to use my arms, right? Maybe not. Will I have to limit lifting because of the chest fat grafting or because of the donor site?
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sandra - you don't want to compress the area where the fat is applied - you need to be very gentle with it to try to preserve the graft, you only want to compress the donor site. The reason compression is used at the donor site it to prevent fluid accumulation in the cannula tunnels, and/or a belly seroma, which is bad news. You don't have this issue with the graft site because a different type of application is used to graft the fat than to harvest it. I have had abdominal donor site twice, the first time was multiple sites on the abdomen and hips - including upper abdomen, the second time just lower. I could use my arms but had the same lifting restriction as with any previous surgery - and it is due to both the donor site and the graft site. I could move around without a problem, but I was sore like I did 1,000 sit-ups. You will be able to move, just slowly.
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Thanks for the great information SpecialK. I was not aware that there is no need for a compression garment on the chest area, good to know! We are hoping to accomplish two things with the FG. Fill in pockets and ripples and also, just hopefully, alleviate the pain I have been having on the right side with the latissimus muscle. This pain has been since two weeks after the mx. I am in so much pain that I can only wear a bra for about 2 hours, then this nerve or muscle just screams at me. I have been putting up with this for almost 2 years. Therapy doesn't help and working out at the gym doing light weighs to try to stretch the area is not working. I am at a lose with what it could be. PS thinks some fat in the area under my arm would possibly help. I'll try anything! Did Breast Surgeon nick or clip a wrong muscle during mx? I just don't know!
Anyway, tomorrow is the day!
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I hope I didn't confuse anyone about compression. I am in compression from my knees to the upper abdomen, not the upper chest.
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One of my friends warned me about oozing from the donor site. So I guess it's really true! How are you feeling, JB?
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jbdayton - that looks ouchie!
Julie - I did not have issues with this, but if they use tumescent technique they introduce liquid, so you can have oozing. This last time I was glued with dermabond so I had zero oozing. My surgery was Nov. 13 and I am just now losing the dermabond.
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Julie and Specialk I am doing great. The compression actually feels good at this point.
I saw my PS this afternoon and he is quite pleased. He does think we will have to do another small touch up and he can do that at the same time as the nipples. We will make that decision at my Dec31 appointment.
I am in the recliner with just a cami and panties on while the garments dry. Heading to the shower in a few minutes. I hope it feels like heaven.
I had minimal oozing at the breasts. I had lots of drainage at the hip because he took a lot of tissue by lipo so he could avoid another incision. I had to have the hip removed for symmetry. He used my other hip in June to make my right breast. I do like the new figure though. Now next year I can get back to the gym and tighten everything back up.
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Interesting. I'll ask my PS more questions. Surgery scheduling told me I night not be scheduled for surgery until February.
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K, who is this guy of yours?! I wish my PS did that. I have tumescent, and I ooze like crazy. I mean, a lot.
Getting ready for the sixth procedure of the year on Monday. Yikes!
Hi Julie!
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Good luck, Bobogirl.
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bobo - Lol! I think it is just me - I have had drains with several surgeries (not FG) and I always lose them in less than a week, even with the BMX.
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You too, Julie!
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So there will be an incision at the donor site or two or three? I was thinking it would only be a small opening like when I had lipo to one of the mudflaps. I guess I don't understand what tumescent technique means and how it is different than lipo. Educate me please.
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sandra - I only had what are called "stab incisions" - not even an 1/8 of an inch - mine are dermabonded closed, no stitches. I don't know what others have had. My PS makes them at the ends of other scars so I have no "new" scars. Of course, I have a lot of scars to choose from, lol!
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Sandra. I had one incision at the donor site. It was on my belling button so I don't even see it.
When my ps put the fat in my breasts I had four small openings. No scarring.
I think each ps does it their own way.
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I had lipo for one of my mudflaps earlier this year and except for some world class bruising about the size of a salad plate and a bunch of soreness, it was uneventful. I thought my upcoming fat grafting procedure would be about the same, just more fat taken during the lipo portion of the procedure. After reading here about tumescent liposuction, I realized I don't know enough about lipo and should have asked my PS. I Googled and read about the different kinds of lipo, how each is done, and the complications. Holy Crap! Wish I knew what my PS is going to do and how much he is going to take. I read they can take up to 4 liters but the complication rates go up depending on how much they take. Now I'm scared! People die during lipo!!!!! I had no idea. The drugs they use to bathe the donor area during the procedure can mess with your heart.
Those of you who've had more than the little bit I had, please fill me in. I need an education on lipo apparently. Why is tumescent lipo chosen over the regular kind?
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sadra - your PS is only allowed to take as much fat as is needed for your revision. If he takes any more than that insurance can deny payment and term the procedure "cosmetic" so I would not be too worried. These procedures are coded as breast revision, and the insurance company gets a copy of the surgical report with the amounts of fat taken, and fat injected - this is very different from a lipo done for removal of fat for aesthetic purposes. The folks who have serious complications are usually those going in for a large quantity of lipo, and/or have not been properly screened for co-morbidities prior to the surgery. Your PS is well aware of your medical history, and has been with you through enough surgery not to do anything that would be complicating for you. The only topical used for me was Betadine - normal for most surgeries, although I will warn you I went into the OR without any pre-meds and stood in a sterile field, was painted with Betadine 360 degrees, then laid down on the table myself on another sterile field. What this means is that you get no Versed, or other relaxing med, until you are already in the OR and into the process - it is a bit freaky. Lipo prior to tumescent procedures used to result in a lot of bruising, my understanding of using tumescent is to cut down on that. I don't know that everyone who gets lipo for revision has tumescent, since a smaller quantity of fat is removed. You would need to check with your PS to see what his plans are regarding that. Four liters would be like four big bottles of soda - I seriously doubt he will take anything near that much - I probably had less than a cup taken, this last time half a cup.
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Good lord, K, that 360 thing while sober sounds freaky. Thankful my PS does not do that! He makes me stand up at pre-op and marks me with pen. Tomorrow, in fact. Hope pre-op meds are still in the mix.
I have tumescent, and I bruise like nobody's business. I think I am just that kind of person. He usually takes 250 plus 275 ccs (or a little more). XX0
