Fat Grafting, pros and cons
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Hi ladies. I just wanted to pop in quick. I spoke with my ps today about setting up a fat grafting procedure. She mentioned probably only needing 100-200 ccs. Is that typical? It's mainly for filling in a dip over the implant on my chest wall...0
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mommy - yes, they are only allowed to take enough to fill in the defect, so as not to be confused with a cosmetic procedure and then denied by insurance.
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Rubi -- I didn't use compression for my DIEP surgery or my first fat grafting (donor site was upper abdomen). My PS did not believe it would be helpful for either procedure (he's a very well respected surgeon, but based on what's I've read on this site, seems very loose on all the "rules"). I'm having another fat grafting procedure at the end of March, and he is taking more from the donor site, so I'll see if he has any recommendations for me then.
Good luck!
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Thanks special k0
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Rubiayat, that definitely is unique situation! How did you get the indentation on your inner thigh? Did they take too nuch fat from there in a previous fat grafting? Can they take fat from your stomach to put in your thigh?
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I had a TUG and my thigh was the donor site for my flap. It is kind of funny that I will have fat taken from one part of my thigh to replace the fat/tissue taken from my inner thigh. I want my thighs to be even, so I prefer that my PS take fat from my outer thighs and I don't think I have enough in my stomach for my breast and thigh. I'm hoping my PS can increase my reconstructed breast by a whole cup size. It is truly amazing how they just shift fat/tissue all around your body!!
Thanks for the input Ridley. There does seem to be different schools of thought on compression.
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Ok ladies, I'm counting on you to not down play the gealing time for fat grafting. When I spoke with my ps she said 1 week should be more than enough for recovery... Sounded like the donor spot would be upper abdomen... Is this realistic? I am a kindergarten teacher with a very... Let's say active class lol0
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I've always heard a week but it might be harder since you're kindergarten teacher and you are probably moving around a lot!
I just had my pre-op today and asked for a total of 11 days off. It's only 7 work days but the 2 weekends make it 11. She is going to target my pointy thighs
One week to go.0 -
Good luck Julie0
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Thanks. She said she will put a stich in each thigh but not up top, but that I will still ooze a little. I asked her if it is ok to stick a pad or gauze in my spanx and she said yes. I wear tight spanx 1-3 weeks and no bra. She didn't want anything compressing my breasts.
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Julie if u don't mind my asking, what type of implants do u have? What is ur fat grafting for?How many ccs did ur ps say they'd use? Mine said only 100-200ccs.0
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I have Allergan style 20, 550 cc whch my ps says are too heavy for my frame because I have a slight droop. I forgot to ask how much she would take out and put in. I'm guessing it will be around that much. I have some rippling in the upper areas. When I stand up really straight, with my shoulders back, you don't notice them. But if I stand normally, you can. Even more so if I bend forward. I have a thread on the picture forum and I will need to post before and after fat grafting pictures. I really don't want my cup size to get much bigger because I already feel quite busty!
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I have allergan style 20 also but 750 cc. Above the implant on my dancer side is a bit concave looking since all the breast tissue was removed. I'm a 40d with these implants. I'm sure I'm heavier than u so these bigger implants actually look like my natural breast, however for whatever reason the left droops down more than the right. My ps said I need to just get used to the imperfections, reconstruction isn't about fixing everything it's about giving you something to make you appear normal in clothing. A good bra will hold up the droopier breast.....0
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Yeah my ps said to always wear a bra except to bed.
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One week is NOT going to do it. I'm at 4 weeks and while I would have been able to go back to work two weeks ago, it would have been pretty uncomfortable. My abdomen was still mighty sore at that point. It still hurts in spots, somedays more than others. My chest is tender too but the swelling is down. Today I saw my PS and had an errant suture removed from the one abdominal incision that isn't completely healed. The other five are fine. They still have scabs on them but are essentially healed. The one that doesn't want to heal all the way is tiny like the others - less than 1/2". The skin is reddish but the PS says its fine and will finally heal over all the way. For some reason the dissolvable suture...didn't. I thought maybe he would put me back on antibiotics. He said no - it's just irritated, not infected.
My PS says he is completely pleased with how well my body has accepted the fat from surgery #6 and the AlloDerm from surgery #5. He doesn't think any of the fat grafts have failed, which is wonderful. Often this has to be done more than once because fat is absorbed or sometimes it dies. He is extraordinarily pleased with me and told me I've been a "perfectly compliant patient with good fat." So after he took some "farewell - you are finished" photos, he declared me FINISHED. It took 5 additional surgeries to fix what the infection destroyed, but we did it.
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Great news Sandra. I know you are so happy to have reached the end.
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Sandra - so glad you are DONE!
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Sandra, congrats on being done!!!
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Sandra WOW! What a journey. Sounds like home stretch in front of you. I got a staph infection after my first mx with TE. Set me back somewhat with extra scarring and lower boob skin tightness. Not nearly as devastating as yours though.
I am 16 days out from exchange (both) with FG on the right (Oct. mx) I already had fat left over from 3 Brava/AFT procedures on the left side. My right side looks perfect in shape and size (Allergan 410FF) Because of the fat in place on the left, a 410MM was installed. That side has a higher, plumper profile and less fullness on the lower side. Compared to the right, the left side looks like she wants a career in stripping or porn! Might need some adjustment down the road. FG donor sites not too sore at this point.
Like you, Sandra, ready for BC to be in my rear view!
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Hi ladies. I'm new to this thread. I had the TUG flap for my areola/nipple reconstruction on 12/19. Two and a half weeks later, while at work, the sutures opened. I started shaking really bad. I left the office and headed straight to my PS. Surprisingly I did not have a fever or infection. It was just painful and frightening. I've been out if work for two weeks to recover. I have to put silva deme cream on the open wound, gauze, and obviously tape it up constantly. She sutured it loose in my opinion. It still looks red and raw but it's much better than it was. I am to finish the jar of cream and follow up next week, when hopefully I can stop the gauze and let oxygen take over. It looks pretty ugly and I realize it will for a very long time. Has anyone else had a complication? Any advice is appreciated. Thanks so much.
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Sandra I'm so happy for you!! I am trying to figure out timing on my fat grafting... I see you said one week isn't enough... The only possible date that ps gave me so far was march 23. This was my thinking on this- I go in Monday march 23... Take off the week and return on march 30. This is a 4 day week for me and right before break so it'd be low key. Do you think being up and about from 730-300 is unrealistic? I can sit when needed... Kind of.... If I can get through march 30- April 2, I would then have off until April 12!!!! The only other possible option, she was going to look into it was April 8, but then I'd be off until April 12 and need to work the following week- April 13-17. The only saving grace would be I need to do kindergarten screenings April 14-15 so I'd be sitting all day. With the upper abdominal fat grafting, what is more uncomfortable sitting or standing? I might just have to suck it up as long as I'm off pain killers and can drive. Do these options seem practical?!?! Otherwise I have to wait until the summer... Another summer ruined by surgery!😭0
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mommy - it depends. Since you are having 100-200cc, correct? That is not very much, so your discomfort may be more manageable than Sandra's was - I believe she had more taken. I did not find standing or sitting to be uncomfortable - it is movement - for an abdominal donor site, it is getting up and getting down that hurts. Being out for a week may be enough to return to work, but not be discomfort free. I did all kinds of stuff after my last FG, including drive within a few days after to the post-op, drove myself to an oncology appointment a week after, and drove an hour each way to a party that I stayed at for several hours. I also cooked a big Thanksgiving dinner two weeks after and all I needed help with was lifting the turkey. I also did the grocery shopping and just had the bagger load my groceries for me.
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Thanks special k! Yes she said probably 100-200ccs. There are other things going on like drooping on one side and a divot but she said she won't touch these NOW... Not sure when she gets in there if that'll change but.....
I just don't want to jeopardize the fat grafting taking or causing problems by doing too much too soon. Thanks for sharing your experience. By the way, what are the restrictions?!0 -
If you are only getting 100-200 cc's, you shouldn't have much of a problem. I had 1,000 cc's taken from 6 incisions -2 on either side of my upper abdomen, 1 in the middle a couple of inches above my navel, and 3 across on my lower abdomen.
Except for the first day or so when my chest and abdomen felt like they were burning, you won't really need pain drugs. I only took Tylenol the first two days. Nothing after that. As SpecialK said, if you aren't moving, there's no pain. Getting up was the worst for me. My abdomen would hurt sharply for about 15 seconds, easing up as I stood upright. I didn't see the point of taking something that I would only need for 15 seconds every hour or so when I got up to go to the bathroom. There was a period after a week where there were some random zingers from a few of the ab incisions, but they were unpredictable and only for a few days so again, no point in taking drugs.
Just like after any operation where you've had general anesthesia, you'll feel tired and achy for awhile. I also had some swelling on my chest which limited my range of motion but didn't hurt. My abdominal incisions are still tender at 4 weeks. Yesterday I had an echocardiogram of my heart that hurt. The tech pressed back and forth near my sternum - which had me flinching. Then she moved to my side at the bottom of my left breast. I'd had a lot of fat grafted there to fill in where soft tissue had been lost in my infection. I also had scar revision and mud flap removal in that area, so having the tech pressing so hard was painful. I also had a cardiac CT scan that day and had to hold my arms above my head for awhile. I'm quite sore today.
The center incision on my belly is a little red but all the others are healed. The PS took out the stitch a couple of days ago and now the incision looks wider. It wasn't quite healed so without the tension of the stitch to hold the sides together, it's spread out a bit. There is no infection. The PS says its to be expected and it will heal. Today a person walking in front of me turned around suddenly and knocked into my belly with her purse. OUCH. I can't imagine a bunch of little kids running around near me. I'd be worried at this stage that someone would bump me in the stomach or chest.
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Thanks Sandra! Geez kinda has me second guessing if I should wait for summer. My kids were so looking forward to me being able to swim with them this year and be more active though!!!
Well I definitely need to weigh this out a bit. They penciled me in for march 23, but we're going to check on a date in April too... Got to figure it out soon!! Supposed to have my 6 month appt with bs on march 26 too....0 -
mommy - my PS has pretty strict restrictions - 8 weeks in 24/7 compression at the donor site and no exercise other than walking for the same period. Same type of lifting restrictions as after mastectomy.
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My ps only said compression but didn't specify how long. Once my appt is booked I'll have to get the specifics.0
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I had fat grafting last May and will probably get a bit more done to fill in my awful lumpectomy scar and a bit more on the radiated boob this May.
I am small--A cup and went a bit bigger than I had been originally, to a small B, probably (I had a BMX so both boobs done). I was 1)bruised for about 3 weeks, like I had been in a bike accident, 2) a little sore, 3) don't remember using compression at all, 4) could do everything I wanted by 2 weeks? The donor sites were my hips and a bit from my stomach. Not much fat taken from those sites b/c I was, and stayed, small.
My PS said that stem cells from our own bodies can regenerate some sensation (his wife, who had a BMX, got some sensation back after this procedure). Nothing yet in the boob area but I used to be numb under my arm b/c of the large lumpectomy surgery I had.
I can NOW feel my underarm completely. So...
Claire
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Yep, SpecialK's PS and mine have the same restrictions. The fat that was injected has to find a blood supply and kind of "take root" so he said to restrict movement and carrying just like after BMX and no exercise except walking, no bouncing of any kind, and compression. I asked about the heavy Velcro compression band I've had on 24/7 for a month now and he said I could go to something less restrictive, like Spanx or Genie Cami Shaper if I wanted to. There have been several times that I've taken off the compression band for a shower and taken my time putting it back on. I don't realize until I put it back on how much better I feel with it.
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Any thoughts on fat grafting improving the cold feeling? It bothers me that my breasts are cold to the touch. I would also love some nerve regeneration! Thanks, Claire.
Congratulations, Sandra!
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