Fat Grafting, pros and cons
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I have had extensive fat grafting. While my implants still feel cooler than the rest of my skin, they are not cold. I really think the fat grafting has made a difference
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I did not get any fat injected between the implants and the skin. My doctor said there has to be adequate blood flow and my tissue is too thin to support more fat there. (It is very cold, by the way, because of lack of padding. The other one is better.) Plus injecting small amounts of fat in such a shallow place is quite difficult. He has to be careful not to pierce the implant.
My 1,000 cc's of fat grafting was put under my left arm, down my left side, and across my chest beginning a few inches above my implants.
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Elizabethaw Due to my previous Brava/AFT attempt, I have more fat in more places on the left, and that is the warmer implant side. Less fat in fewer places gives me a cooler implant on the right. Will let you know if things warm up over there as time goes by. Right mx was Oct. 1 and exchange (both) was exactly 3 weeks ago, with some FG (right). Hoping for some more sensation to gradually work itself across the numb areas myself.
Sandra - I am with you on that abdominal compression band. This last time, not that much lipo, and not that deep. Still a little tenderness, but just barely. I was told to massage the incisions, but not the implants. I have Allergan 410 anatomicals. They are much more comfy than the TEs for sure.
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Hi, ladies, I'm just wondering if anyone has had or knows anything about having fat grafting for the purpose of filling in a dent or defect left after lumpectomy? I'm 9 days out from my lumpectomy for DCIS; the tumor was 2.4 cm, about twice what the pre-surgery prediction had been. I also have very small breasts—it may seem like a good thing that my DCIS/surgery was in my slightly larger, "better" breast, but what I have is a fairly significant dent in the lower aspect of that breast, not a more symmetrical match for my smaller breast. In the general scheme of things, I guess it's no big deal and I feel lucky that no invasive cancer was found. But I'm wondering if fat grafting could restore a more natural curve and symmetry to my breast without anything else being done, such as implants, which I really don't want. I'm used to my small breasts and not looking for any major augmentation, but it would be nice if the girls matched and the deformity in my left breast could be repaired. I would probably also want to have a small amount of fat grafting to even up the right breast—and already, reading through the posts here, I can see that this would probably not be covered by my insurance, right? Also, it sounds as if the fat grafting is a pretty big deal in terms of pain, recovery, and potential complications—less than other kinds of reconstruction, maybe, but not something to be taken lightly. I'm an active 64-year-old who rides horses and does other athletic things, so this is a consideration. Just hoping to get some good advice from all the combined experiences here! I would have to wait until later, after I complete radiation, to address the defect left by surgery, and I also realize there could be some further changes caused by radiation. Also, is lipofilling the same thing as fat grafting, or something different? Is it only a matter of how much fat is transferred, or a different technique or purpose altogether?
Thanks for your help!
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elizabethaw - some do, some don't - it is crapshootland. Also it depends where the fat is being put, how much, and for what reason.
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Thanks to everyone who answered my cold-boobs question! SpecialK, so much of this process is "crapshootland"!
I've got very visible rippling--including 2-3 major indents (valleys instead of ripples!)--and as the implants settle I can see the outline at the top more and more. I'm getting near 5 months post-exchange. My PS advised I wait about 6 months after the exchange to do the FG.
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Kayfry, I'm not familiar with the term lipofilling so I can't help there. The pain in fat grafting comes from the donor area and apparently is directly tied to how much you have removed. Some with only a minor amount taken aren't slowed down much at all. I had liposuction last spring to remove one mudflap (dog ear) on my side which is common after a mastectomy incision. Even though it wasn't a large area, there was quite a bit of bruising and it was sore for quite awhile. But it wouldn't have slowed me down much at all. It was minor. This time I had a very large amount removed and replaced in all the valleys and dents. I had no bruising but significant pain for several weeks. It was part of reconstruction. I don't know if insurance pays the same way for lumpectomy patients.
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kayfry - It is unlikely for your insurance to cover fat grafting to correct a lumpectomy defect unless you live in a state that has legislated it, and I don't believe that there are many. Federal law covers revisions only after a mastectomy, and fat grafting is considered by many insurance companies as a revision, so if you have had a mastectomy it is generally covered. The amount of fat that needs to be harvested can be correlated to the level of discomfort afterward, but this is definitely surgery, although outpatient. I would advise that you wait until after radiation and then let some time pass - often the dents fill in. Possibly peruse some of the lumpectomy threads and chat with the ladies there and ask them if this happened for them - I know I have seen posts regarding this, and it seemed to take a bit of time before it happened. Also, fat grafting and lipofilling are interchangeable terms, although lipofilling is used for other plastic surgery purposes than just correction of breast defects.
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SpecialK, thank you! This answers a lot of my questions. I have been hanging out over at the "Lumpectomy Lounge," but this particular question hasn't seemed to come up so much. I see from your profile that you have had a very long journey, and my hat is off to you. My concerns right now seem trivial in the face of that, but I do so appreciate your response. I hope you're doing well now.
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Just curious... Is there a risk for lymphadema when having revisions like fat grafting or is it only an issue when dealing with nodes?0
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kayfry - glad to help! I am doing well, left breast is not. Or rather, where a breast should be, or something should be, lol!. My left implant was removed in May after problems resulting from allograft repair in March, and skin repair in April. I had a fat graft in Nov. to try to improve the skin before doing any more surgery, but my insurance is balking at paying even though they authorized the surgery. I am in a state of limbo right now as my PS would like to do another fat graft before trying an expander under my fragile skin, so... that is the state of affairs.
mommy - any time you have a revision surgery after breast surgery you risk lymphedema.
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New to this thread, but I tried to read everyone's responses before posting. Great information! I might be in a slightly different situation, but hoping to get similarly good results as many seem to have had. I am 6+ years post mastectomy, and when I originally had my surgeries, I didn't have enough ab fat to do grafting, and it was still a pretty new technique. Fast forward to today, and my PS says they are regularly offering FG to anybody who can be a candidate, as part of reconstruction, as they get much more natural-looking outcomes. I'm now 49, so I'm finally getting a little "padding" around my belly button, so my PS says he can get enough fat to fill in some rippling/wrinkling and low spots here and there. Plus he said he would try to release some of the scar tissue ("sticking") that has occurred. I'm not expecting perfection, but I'm hoping the results will be worth going through yet another surgery/revision. I decided to postpone my surgery until late April, when a large work project will be done, so I can recuperate without the stress of a huge pile of work.
My PS said he could get the FG from my abs (around my belly button) or my thighs, but I prefer my abs, as he will go through two small incisions right below my bikini line. I would think going in through my belly button would be closer to the donor site, but has anyone had their incisions below the bikini line? I'm expecting lots of bruising and pain, but I'm not worried about it. He said he would go through my previous scars around my areolas to inject the fat, so no new scar locations. Also, for those who have completed their FG procedures, are you satisfied with your results? Like I said, not expecting perfection, but I would like both sides to look much smoother, less dimply and "wrinkly".
Thanks for your input!
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marketing - I have had FG with the donor site below the bikini line twice. I have had two C-sections and an abdominal hyst/ooph and he placed the tiny incisions to remove the fat at either end of that scar. I did not have fat placed over implants, rather above to fill divots above the upper pole the first time, second graft was to help my skin after my left implant was removed. I found that things looked much softer and more natural after the first procedure and was very pleased with the outcome. Good luck!
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My fat grafting today went great! She took out extra from my thighs and took more than she needed...600cc total. I put pics in the picture forum but here is a pg rated post op picture. I always wake up feeling great and smiling
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Welcome Marketingmom. I also had some low donor sites (three across) as well as one a few inches above my navel and two others near my hip bones. There was absolutely NO bruising whatsoever which I attribute to the tumescent procedure. The tiny injection points on my chest and on my left side were closed with very fine absorbable stitches which went away just after week 3. You can still plainly see the marks but they'll fade just like all the others have. It just looks like I have some scattered measles on my chest! There was no bruising except for a few of the sites which had faint yellowish marks in the 2nd week but went away completely in only a couple of days. I'm 5 weeks out tomorrow. The center belly incision is still a little red and my abdomen is sore to the left of it (??) but everything else is healed. Nothing else is tender, which is an improvement over last week at this time.
All in all, even though the donor site pain was pretty ferocious for a week or so, it was worth it.
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Julie, You look great - and glad you woke up feeling so happy! Hope you heal well!
SpecialK and Sandra, thank you so much for your posts, really good info. Based on this whole thread, I have been compiling a list of questions for my PS. I already had one additional appointment with his NP (who happens to be his OR nurse and told me about wearing Spanx and a few other bits about recuperation time, etc.). But now I have more questions that I will certainly ask before the procedure. He had made no mention that FGs sometimes don't take and need to be repeated (hoping one will do for me).
I haven't been on this site for so long, but used to be on quite a bit after my original surgeries and treatment. I need to re-request access to the picture forum. My PS had no photos of results I can expect, and I would like to manage my own expectations before going under.
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So I had my fat grafting on Thursday and I took these pictures of my thighs last night. Lots of pretty colors! They are very sore but I just take regular tylenol. I only took Norco that same night. My foobs look great and I hope the fat stays around. I need to go braless for about a month. S
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Thanks, Sue. I have smooth round Allergan Style 20, 550cc. I did the fat grafting because I needed these things fixed - a dent, some rippling, divots near my armpits, and I asked her to add some where my stepoffs are. The foobs are looking good but I'm only 2 days out. Sometimes my foobs feel too heavy. My PS said to always wear a bra "when upright." Except with the FG, I am supposed to go braless so there is no pressure on the FG areas. I like my implants.
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Julie,
Do u know how many ccs they took during FG? My ps said probably only 100ccs, which doesn't sound like enough to make a difference. She is focusing only on the step off, I have flat ting right above left implant. I also have a divot and drooping but she wont touch it0 -
She took 600cc which is 20 ounces. So around 300cc each side. She didn't use that much up top. I'll have to ask her. I didn't see her after surgery but I will see her next Wednesday.
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Thanks Julie. She's focusing on just left, not sure she's doing anything with right...0
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Julie, I'm so glad you're doing well! I'll be looking forward to hearing if you see a difference in your thighs and how you feel.
Best wishes!
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Thanks, Elizabeth. I'm less sore today. I read it can take weeks or months for all the swelling to go down to see the final resuls.
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Julie, I saw a difference at the 3 week mark when I realized the swelling had gone down considerably. So sorry you have that quite colorful bruising. If you ever have fat grafting again, ask your PS about using the tumescent method...no bruising! Of course the pain is still there, but it doesn't look bad so somehow that makes the discomfort easier to take. I'm 5 weeks post op and have one donor area that is sore and the incision near it has a tiny 1/4" bit that doesn't want to heal completely. It's still a little red but isn't open or draining. It's just not healed over like the other 5 tiny donor incisions are. The tiny injection areas on my chest are fading but still quite noticeable. The dissolvable stitch in each is long gone and they are healed, just not gone. I had a top on today that was lower cut and my chest looked like I had some almost healed zits on it! They are scars - tiny scars, but still scars so maybe it will take a year or maybe they'll never go away completely.
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Thanks, Sandra. The bruising and soreness are getting better. I have 2 holes in each thigh that hacve steristrips on them and then I have around 10 red dots on my breasts. Three of those have little steristrips on them. I have no idea if she used stitches anywhere. My post op is in the morning so I will ask her.
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She took out stitches from my 4 thigh holes. The 3 sterastrip spots on my chest were where she wanted to use a cannula rather than a needle but she said no stitches wee needed. She said she took out A LOT but didn't use that much on my chest.
She also said I did bruise more than the average person. She said I didn't have to wear spanx anymore if I didn't want to but I am going to keep wearing them for awhile. From what I have read, it helps with swelling and the final result. She said I can wear bras that don't but pressure on the fat grafting areas. I think I'll wear genie bras when I return to work Monday. She said it can take 3-6 months to see how much of the fat will stay. So far so good.0 -
Yay! Progress! You are well on the road to recovery. Just wish there was a way to hurry up the donor site pain.
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Julie, how much time did you take off work? Sorry if you already said and I missed it!
Has anyone had FG that gave any increase in size? I'm still feeling smaller than I'd like.
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Elizabeth, I had surgery last Thursday and I am returning Monday, 11 days later. My thighs are still sore and I walk slow. I probably could have returned at 1 week but my entire office is moving to a new building and everyone would be packing boxes those 2 days. I did all my packing before!
As for an increase in size, I probably still have swelling so it is too soon to tell. I swear my cleavage is great right now and they seem softer and warmer. I hope most of the fat sticks around.
Also, because of swelling, the scale went up about 4 pounds. I've been reading about lipo and this is normal. Now I'm just up 2 pounds. I have stuck to my low carb diet so I know it's just water weight.
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