Fat Grafting, pros and cons
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Yes. I agree with SpecialK. I just had my FG on Thursday. It went wonderfully. I have about 5 areas with one stitch in each area from the donor site. In the breast area there is about 8-9 areas with one stitch in each area. My bruising is very minimal, so far. The only pain I have is the stomach, getting up from the couch using the stomach muscles kinda takes my breath away. All in all, I am very happy. They look and feel is so real. My implants have been slightly painful and uncomfortable, this has given me a whole different feel, more natural and softer ! I will know more over the next few weeks
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bobo - yeah, it was weird - plus I am standing there uncovered from the hips up with a 650 implant on one side and saggy baggy elephant skin on the other side being painted with a betadine sponge while people are bustling around and the anesthetist dude was chatting away. It was a bit Fellini-esque - they were all covered up except for their eyes but I am wearing nothing essentially.
On that note - hope all goes super tomorrow - you know I will be thinking of you! And checking on you! I am flying up to D.C. tomorrow, through Wednesday afternoon, for my last vaccine booster but I will check in. Is this your last one? Did you have a sensible chat with the PS?
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I know what you mean about standing in the OR while everyone is doing their pre-op routine. I once had a procedure where I walked to the OR. I dropped the hospital gown and the surgeon started drawing on me with his lovely purple marker. Nobody was paying any attention...they were busy setting everything up, but it was very surreal to be the only one with no clothes on. I was surprised how many people were in the OR and was checking out several tables with instruments laid out. Up to that point I was handling it just fine with no pre-op meds, but suddenly I could feel myself starting to pass out. So I said, "I hope you are finished because I've got to lie down on that OR table now or I'm going to throw up and fall down on the floor." I made it up on the table just in time to fall over. I much prefer getting Versed prior to the procedure and having a nice ride into the OR.
My PS was attending the San Antonio Breast Cancer Conference here in town last week so he wasn't around to ask a question about whether he would be doing the tumescent method. He doesn't have the typical office staff like a civilian physician so getting an answer isn't easy. He is the reconstructive surgeon for the burn unit in our huge military hospital and is only in the clinic on Thursday mornings to see pre-op/post-op patients. Otherwise he is in the operating room. My husband works in the burn unit and says even the support staff rarely sees Dr. Chan. I can try to talk to his resident, if I can get somebody to give me his number. Since it's a teaching hospital, Dr. Chan changes residents every three months and he just got a new "minion" two weeks ago. I haven't met the new guy yet. Usually I know the resident ahead of time and have his phone number, but not this time. It's a bit of a pain in the neck but at least with a military hospital I don't have to be concerned with insurance approval for anything the surgeon wants to do, which is a blessing.
My PS is a Chinese version of Doogie Houser. He looks like he is about 20 but he's in his early 40's. He is one smart guy...undergrad degree in biochemistry from MIT and med school at Harvard. In spite of being incredibly busy and hard to get ahold of, when you see him in person he acts like you are his only patient and he has all the time in the world for you. I do trust him and marvel at the reconstruction work he does on our burned soldiers so not being able to get a message to him easily is a small price to pay. I'll try though.
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Sandra, that's funny about walking in. I got to do that this last time, kinda neat. I always tell them no versad. I want to be there when I go in and see my doc. I always talk to the staff as they're getting ready and listening to what they all talk about. Had versad once, don't like it. And it easier to get on the table from walking then climbing onto from the bed.
The new girls are doing nicely and I probably won't need any fat grafting now. Still early so will see how they settle. Hoping to get the drains out tomorrow.
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For my BMX, I was asleep by the time they wheeled me in. For my exchange, I was fully awake and was able to look round the operating room and see my PS. It was weird. I think I prefer being knocked out earlier!
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I had fat transferred 3 times earlier this year when I was having Uni recon using Brava. The first one was at the time of the left mx in Feb. and about 100cc was deposited in the pectoral muscle. The second (in May) was about 350cc and it was deposited in more places, plus some scar tissue in the lower inner quadrant was released. The third AFT (in July) was about 250cc. Two weeks later, one of the injection sites had reddened and thinned and it all leaked out. I was very discouraged, but was willing to continue trying after a month off Brava.
When I was diagnosed with cancer in the other breast in Sept., I was DONE! I have two TEs and will have exchange on Dec. 31. A lot of fat remains on the left. May not need FG there, but I will need it on the right. That will be done during the exchange. Hope all goes well and that both sides BEHAVE after surgery. That left side has a history of being a real troublemaker. I might need a zipper on that side (opened up 4 times so far).
Even though I had that AFT failure in July, I still feel strongly about FG. At least for me. In the TEs, the "fattened" side has been more comfortable.
I am blessed with a very good and accessible PS. We text and when I have had issues, I have been able to text photos and get opinions. She has always been very responsive and ready to address whatever concerns I have had.
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I had my surgery yesterday and was released from the hospital this afternoon. The PS did tumescent lipo and after spinning the fat in the centrifuge, got 900 cc's of good fat to work with. I haven't looked in a mirror yet but from what I can see, there are six small holes around my abdomen and six or seven injection sites on my chest. I'll look in the morning when I shower. Way too tired to do it today. Today I am much more sore than yesterday. There is a burning, bad sunburn feeling across my chest and upper abdomen if I move. If I'm quiet, there is no discomfort. I've only taken Tylenol. Standing up is no fun but after a quick rush of "ouch, ouch, ouch" I straighten up and walk to the bathroom and back to my chair. Restrictions are similar to the BMX. No lifting over 10 lbs, no raising my arms above my shoulders. I have a Velcro ab binder on that is tight but comfortable.
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Chit, chit, chit. This hurts. Can I expect the donor site pain to lessen next week?
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I felt much better after several days. I did find the binder to help this time. I did not have one for my first fat grafting. Just hang in there it will get better.
I am surprised I think my hand surgery is more painful than my breast surgeries have been. I do feel like I am making lots of improvements since yesterday.
The worst part is my husband has to handle my compression garment for me. Luckily it only has to be taken off to bathe or wash the garment.
Hope your husband is doing better and his tests all come back b9.
Keep us up to date on both of you.
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Carpal tunnel surgery is supposed to be SO painful. There are so many nerves involved. Hope things are better today.
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When fat grafting is done is it a one day surgery or do you stay overnight? What types of fat grafting techniques are there? When fat is taken from your abdomen does it leave divots or dents there? Is 2 weeks enough for recovery?0
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I don't know if 2 weeks is enough since this is only post op day 4. But if I keep making progress, I'll be pain free by the one week mark. Hopefully you will too so 2 weeks should be plenty. As it is, nothing hurts if I don't move but getting up and standing straight is still a challenge. Just not nearly as bad as it was two days ago. Then I was shouting "Chit!" whenever I had to get up. I stopped taking Tylenol after the second day.
Normally this is an outpatient procedure but I always have to stay at least one night. They have me attached to all kinds of tubes, oxygen, heart monitors, etc and put me on an ICU step-down floor due to my tendency to stop breathing. Yes, you will have general anesthesia but ask for TIVA, a type that doesn't use gases, and have them use propofol to put you out. You don't get sick afterwards and it has a short half-life so it gets out of your system quickly. Ask for a scopolamine patch behind your ear and an Emend tablet before surgery. Ask the anesthesiologist to make sure you are given IV Zofran - it also helps with any post op nausea.
They inject epinephrine into places on your belly or hip then use lipo to take it all out. I had 1 liter of usable fat after they put it in a centrifuge and spun out all the epinephrine and blood. I don't see any dents or any sign it happened at all for that matter.
My PS used a tumescent procedure. You can Google it to learn the details. I don't know how it differs from other kinds. I have no bruising so far. There are 6 tiny holes around my abdomen and 7 on my chest with one stitch in each. I also had quite a bit of fat injected into hollow places on my side.
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Thanks Sandra! I'm glad you're doing well!!! Thanks for your info. I'm not looking forward to meeting with my ps as the last time I was there she pissed me off and I walked out. This should be interesting lol. I have an observation at work/ I'm a teacher on January 12 and then January 13 I meet with ps- talk about stress!!!! I'm going to be planning my lesson all Christmas break ugh . Oh well, take care and heal quickly!0
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mommyathome
I have had fg twice. Last one was November 10. After a week I felt good. The lipo was done through my belly button so no scars. I had four entry spots on breasts but they were so small that they are gone. I had small pricks on my chest since my ps lifts up the skin when he puts fat in. Six weeks post op a lot of the swelling has gone down and I feel great. I believe compression on lipo area is the key.
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Julie, you are so right. I had my husband help me tighten the compression garment and it has been so helpful today. Much less discomfort when I stand.
For the first time, today (day 5) I see bruising on my chest. It's nothing like some of the fat grafting photos I saw posted on the photo website, but I see the skin is just turning yellowish in spots. The photos I saw looked awful...big dark bruises all over her chest. I still see no bruising on the donor sites.
I wonder if the tumescent method makes a difference? Here's link to a graph that compares conventional liposuction with tumescent lipo.http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2840906/table/T0001/ The graph comes from a website which explains each kind in detail.http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2840906/
I've also learned that the burning feeling is quite common and has to do with the sensory nerves being bruised or stretched during the procedure. I don't feel it anymore.
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Fat graft Nov 26, thought switching to mentors was going to be the surgery, but FG was done also, both procedures to correct scalloping of the orig implants. OMG black and blue girls and all around thighs from butt to knee - scary. I didn't google FG before hand since didn't think that was going to happen, certainly googled it after seeing those bruises. Regarding pain, after mastectomy and other surgeries, I go the oxy, melocarbanol, and promethazine for three days as a routine now, no need to chit chit chit. Wow what a journey, really should be a booklet to each patient with photos before hand to reduce the surprise/anxiety stress seeing it on self first time and not knowing if normal.
So, will my girls get bigger if I eat pasta since FG came from thighs?
Okay, common humor ... but seriously to avoid a recurrence scare ... I learned through a very scary couple of weeks that large tissue damage and bruising can cause oncology visit blood tests to show VERY high numbers for liver stuff. I tried to explain it was likely from surgery and give it a couple of weeks - but the doctor was ghost white and voice was stern to get tests for liver Mest. Wanted to pass that along so others do not have to sweat the liver mest suspense experience ... tissue damage and bruising can make those numbers rocket. Thank you for all your posts, I learned so much today, and I too all my life ate the foods that I just realize may be risking the FG take. Improved Health and Happiness this new year.
yes, spanx and pajamas, I agree ... too weird/funny
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Cif I didnt know about the blood test thing! My FG surgery is scheduled on Thursday, January 22nd. I planned to work the following Thursday but I think I'll take that next Thursday and Friday off so I'll have 10 days to recover. She's willing to take it from my thighs which are my trouble spots.
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cif what foods cause problems with the fat grafting?
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What did you all do for pre op/consultation for fat grafting?0
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Mommy, my PS took photos of the areas that needed fat grating. We discussed the donor sites and he sent me for a CT with contrast to make sure I didn't have any hernias or something else hiding that could cause trouble during the fat harvest. There was one small hernia so the PS knew to stay away from that area. Easy consult.
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I had my three month post op fat grafting appointment a week before Christmas. At 3 months my PS said that I would have my final result (exceptions are weight gain/loss in the future). Most all of the fat grafting took! Also, my gift to myself to add a bit of fat to my lips took as well. Not sure if it was my diet restrictions/modifications or what, but glad it took. No more rippling on my new breast and I am better balanced, so to speak. (I am a unilateral). I am 51 and I read that the younger you are the better insofar as fat grafts "taking". Well, hopefully it will stick around for years to come.
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EnElle,
What diet restrictions/modifications did you have? I have a consultation with ps on jan 13. Anything specific to ask/request/discuss?
How long we're you in the hospital? Where'd u take fat from? How long did u take off work? I teach kindergarten- what is a realistic time frame for healing and feeling good?0 -
mommyathome - with the exception of Sandra, FG is an outpatient procedure. I have done it twice - most recently in November, for two different reasons, and the two week mark is when I have felt pretty normal. Sore prior to that but able to drive and do things.
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Mommy, be sure to ask what kind of lipo he/she will be doing. The tumescent procedure is wonderful! No bruising at the donor sites and reduced bleeding and pain. They inject a solution of epinephrine (controls bleeding) and a type of lidocaine. (Most people are given general anesthesia for the procedure although I've read it can be done with a local. No thanks.) The small incisions are left open so that any residual liquid can come out. There was only a little, all on the first day. I had regular lipo on one mudflap in a previous surgery and it bruised like crazy! It was very sore forever too but finally did resolve.
I've been in a Velcro binder 24/7 and told to keep everything clean and dry once I left the hospital. They gave me an additional binder so I could wash one/wear one. The donor site feels better with a binder. Don't know how long I'll be in it. My post-op appointment is in 2 weeks. I could shower at 48 hours. Also no lifting over 10 lbs for two weeks. I had scar revision, fat grafting and some other repairs that necessitated a 4" incision under my arm on my side also so maybe the lifting restriction was because of that. I didn't ask if it would have been different with only the tumescent lipo. The donor site is a big "gotcha" but it's much, much better in this second week than it was the first week. There is no pain whatsoever unless I get up and then only for a short time, thank goodness. No need for pain pills. I quit taking Tylenol on day 2. Gravity is not your friend. It definitely gets your attention for 10-15 seconds in the early days and you'll suck in your breath! Just raise yourself to an upright position and it fades away. My donor areas (6 of them) were all over my abdomen. They are still sore but much less so. I don't know how long that will last.
I was in surgery about 3 hours. It takes time to suck all that stuff out, spin it to separate the liquids from the fat, and inject it carefully in just the right places. This is usually an outpatient procedure. I stayed overnight as a precaution because my heart likes to misbehave. You could probably go back to work at 2 weeks. You'll be tired like after any surgery, but it's probably do-able at that point. I'm not there yet so I'm guessing. EnElle and some of the others who have gone before can tell you better.
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Thanks special k and Sandra! So much going on. I have an appointment with my primary dr tomorrow because I've been getting headaches daily. Want to find out why.... Then my consult with ps for far grafting is jan 13. Then jan 19 I have my first bone density scan. I know I shouldn't be nervous for this but I am. No doctors appointment is "routine" anymore! All of this and on top of it I have a formal observation on jan 12! My principal comes in for an hour and watches my every move! Before that I have to figure out my lesson. I'm doing a reading unit on The Mitten. It starts jan 5 and ends on the 12th. I have a lot of planning to do!!! Once I have it planned I need to upload it on the computer (which I don't know how to do) to give my principal. I'm on Christmas break but I'm headed to school this morning for a few hours. To top it off my 10 year old wrote a note saying I hate work. You never get to spend time with me!!! Ugh breaks my heart0
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mommyathome - are you taking an aromatase inhibitor? That may be the source of your headaches, if so. You might try taking it at a different time of day if you are. Don't stress about the bone density - it is different than a bone scan for detecting cancer - I am assuming you are having it is a post-ooph baseline. You just lay down and the thing takes some pictures - easy peasy. Have you been advised to take Vitamin D and calcium since your ooph? Can't help you with the other stuff, but it will all work out! Sorry about your little one feeling left out - can you plan a special day together before school starts again?
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Special k,
No I'm not taking anything except melatonin to try to sleep and viativ for calcium and vitamin d. Yes it's because of TAh/BSO. The nurse said I'd be standing up.... Seems weird lol.
Ya I took my daughter to a basketball game- she plays for grade 5 and 6 and we went to see the high school team. They were away so we drove an hour and went for dinner etc. I understand how she feels left out- unfortunately I am doing a lot of work during this break.0 -
MommyatHome - restrictions/modifications: I took my list of foods that stop angiogenesis and stopped eating them a week prior to surgery and for 3-4 weeks afterward-see list below - and I would have a few toward the bottom (listed in effectiveness of stopping angiogenesis) of the list once in awhile (dark chocolate) and not worry. Apparently it is thought that to save the fat transfer there is needed to form a new blood supply (angiogenesis) to the transferred injected fat. Opinions vary on whether it is true and I thought - it's just food and I can modify my diet to include other anti-cancer foods and other fruits/veggies, etc. for variety in my diet in the meantime- and I did.
I also made healthy fats -grass fed cream, pastured eggs, raw organic nuts & seeds-no peanuts, grass fed beef, hormone free dark or higher fat ground turkey, avocados, coconut oil, sesame oil, red palm fruit oil- a higher percentage of my diet and increased the amount of fruit I ate as fat needs insulin. I also ate more carbs-but only pseudo grains (millet, buckwheat, quinoa), rice and sweet or purple potatoes. NO junk food. My weight was up about 5lbs prior to fat transfer and didn't lose it before surgery and kept it on for about 2-1/2 months afterward.
specific to ask/request/discuss: I would ask your PS whatever questions come to mind. I would want to tell them where I want the fat taken from & if you have to wear compression garments. (I didn't -only had 100 cc taken out-but after a week I wore spanx once in a while because it felt better than my regular clothes.) If you don't have to wear a compression garment- I would go buy some all cotton thin elastic waistband underwear 1 or 2 sizes too big as even the slightest pressure hurt me. Also, get some very loose palazzo pants and loose pajama pants and loose skirts if you don't have them already. I lived in too big pajama bottoms at home and loose knit skirts/dresses otherwise.
How long we're you in the hospital? I was an outpatient. Arrived at the hospital around 630 and was home by 12:30p. (I also had a larger diameter implant switched out in my native breast to match better.) I am not sure if I had tumescent lipo done or not. I you want - I can ask my PS what type of lipo was done-but I am assuming there were several techniques used with the fat transfer and several types of calendulas used as the resulting holes in my body were of varying sizes.. I had a Scopolamine Transdermal Patch and it was the BEST! Ask you PS as after surgery I was able to move around, get into the wheel chair with no nausea and was able to eat a good meal when I got home and sleep well. Great for a quick recovery from anesthesia. I have had outpatient surgery w/o the patch and it was horrible.
Where'd u take fat from?I had fat taken from the saddlebag area and from the muffin top area in the back. I don't have a tummy or lots of fat on the inside of my thighs - I will say that I had fat taken from my "stubborn" fat areas so that may have helped in it taking more (?)
what is a realistic time frame for healing and feeling good? Everyone differs, but I was out for two weeks-til I felt better - I had more pain on the sides by the hipbone-(crease where leg and hip meet) and that lasted for about a month.it was a nagging pain and was annoying, but after surgery, I went off pain meds in 4 days (do not like to take them for very long at all) and I did not take any ibuprofen or Tylenol either. My bruising went away rather quickly, but light shadows of the bruising remained for two months. My skin from the donor sites was flabby for awhile, but re-tightened nicely in about 6 weeks. My breasts were sore for a couple of weeks-even though I am a unilateral, my PS put fat in both sides to even me out.
ALSO - I was very, very careful for my part about not causing any type of infection, since I had soooooo many holes/stiches etc in my body. I used (bleached) towels only once, only washed my face in the sink after my shower (they say 30% of people have MRSA in their nose), did not get my face wet in the shower and used paper towels in the bathroom instead of hand towels and used 91% alcohol in a spray bottle to clean surfaces, bleach cleaner in the shower before every shower and used Skintegrity wound cleanser (amazon) last after I cleaned my wounds with the Whole Foods unscented body wash. I didn't wash my hair until I could lean over in the shower using my hand-held shower head hose. I didn't get any infections....luckily. After 5 operations in 20 months - I feel quite lucky not to have complications/infections. My PS also had me take high amounts of probiotics twice daily (which I was already taking some) right after surgery and for two weeks after along with the standard antibiotics post op.
I had a bit of fat put in my lips for a treat for myself since I was going to be out and the lipo was being done anyway and my lips ballooned up like crazy for a week or two. That fat took too and it was worth it - might as well reap a benefit if I can
Good luck and if you have any more ???s - ask us!
PS - my plastic surgeon did a great job of contouring my donor sites as well as where the fat was transferred. It looks totally natural and great (except for the scars-but these too will fade) I got his name from my breast surgeon-actually they gave me 4 names of plastic surgeons and I asked who has done the most fat contouring and I chose that Dr. Glad I did.
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EnElle, thank you for the helpful post! My fat grafting is 1/22 and I'm making my list of questions. Did you have stitches in your donor sites or did your PS leave the holes "open"?
I am taking off work 1/22 - 2/1 so I'll have a good 10 days to recover
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WOW enelle, thanks for all that info!!! I hope my ps is receptive when I see her on the 13. Tomorrow I'm going to my primary dr for headaches. I've been getting headaches daily! Thanks again for that info! I can start my list of questions now lol0
