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Fat graft entire breast

SkiQueen
SkiQueen Member Posts: 3
edited April 2021 in Breast Reconstruction

Has anyone had fat grafting to rebuild an entire breast? This is obviously to rebuild a small breast. Mine is 34A, maybe even 34AA, unilateral mx. Originally, my PS said I did not have enough fat, I am very, very slender. He thought of implants, but worried about my cross-country ski racing. I do the racing for fun, not professionally, but enjoy coming in the top 3 of my age group sometimes. He knows ski racing is a part of my life. Now he says I can choose between implants, which would require me going to 34B, or fat grafting the entire breast as 34A.There is not a lot of info or pictures on fat grafting a breast, just on helping dimples on implants.

So, anyone out there have any info on this?

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Comments

  • meow13
    meow13 Member Posts: 1,363
    edited February 2018

    No I had fat grafting for enhancement. But I think a lot got reabsorbed. I had DIEP and I could never do sports like I use to, I worry about the abdominal surgery and having core strengh.

  • ABeautifulSunset
    ABeautifulSunset Member Posts: 600
    edited December 2015

    I had my implants removed because I hated them. I had them replaced with autologous fat transfer. No cutting. The fat is taken out through lipo and injected into your breasts. I lost about half of what they injected, but I'm still a small B... And it's all me. No cutting, no scars. It was a hard process and you have to find someone who does it (not easy). I flew from LA to Miami to do it. Also, I'm 5'1, 120 lbs. so not a lot of fat. At one point, I did have to gain 10 pounds during the process, so lots of carbs. It was hard on my body, but may be better than flaps and scars.

    Stefani

  • Misstic
    Misstic Member Posts: 50
    edited December 2015

    I want to do the exact same procedure SkiQueen and it's not easy to find a PS who does it. My problem is that I did a lot of swimming when I was younger and my pectoral muscles are very strong. So I get tendinitis because spasms with the implant. Stefajoy did you do it with Dr K. in Miami ? Did you suffer a lot of pain in the donor sites ? How many days after each procedure could you go back to work ?

  • ABeautifulSunset
    ABeautifulSunset Member Posts: 600
    edited December 2015

    I did go to dr. Khouri. Each procedure was about 5 days recovery (or more). One of them was easier and I was moving around pretty good by day 3, but the other 3 procedures were worse. The donor sites didn't hurt for more than a couple of days. That was easy. The breast area hurt for longer because he builds a "shelf" to hold up and shape the breasts and your own muscle, which he manipulates under your skin, and he does cut a small opening under each arm, which can really hurt for a bit. then you have to wear this plastic cast bra for another week or more (until it comes loose and comes off). You can cover it with bulky clothes though. It was tougher than I thought, and my breasts are far from perfect, but I won't undergo anymore surgeries to perfect them. So, I've got what I've got. They feel natural, are warm and soft. MUCH better than the implants.

  • ABeautifulSunset
    ABeautifulSunset Member Posts: 600
    edited December 2015

    I want to add, when I say 5 days recovery I mean that's when you can get out of bed and move around well. He doesn't even take the dressing off for at least three or four days. I had various levels of pain and discomfort for almost a month after each procedure.


  • Misstic
    Misstic Member Posts: 50
    edited December 2015

    Thanks for sharing, Stefajoy. As you, I don't look for a perfect breast but for a natural one. I was enough lucky to not get radiation therapy so my skin is pretty ok for this kind of procedure. Plus my mastectomy was a nipple sparing one with a scar in the middlle of the way between my armpit (for my sentinel node) and my flank. So I think I could be a good candidate to get a nice result, at least a natural result (for the moment my implant is hard like concrete). I have an appointment on january 5. I will tell more then.

  • SkiQueen
    SkiQueen Member Posts: 3
    edited December 2015

    Thanks for all your responses.

    Stefajoy, you gave me some hope! It does sound involved and not easy. I wish I could just leave everything "as is", but psychologically I want reconstruction. I am very worried I won't have enough fat. I am 5'6 and 110 pounds. I eat like a trucker, but cannot gain weight. 10 pounds would be perfect! So, carbs did it? I need your menu😋

    My PS says he can do it, but I have no idea if he's ever done it before. Especially an entire breast. I have confidence in him because I had a huge area of cancer cells on the surface of my skin after the mastectomy. I needed a second surgery to remove them, but no one knew how to close me back up; the open wound would be too large. Skin grafting seemed the only way. But my PS took skin around the site and twisted it over the wound. Apparently, this was impressive stuff. However, I need to remember this does not mean he knows how to fat transfer! Ugh. Is there a list of PSs who do this?

  • ABeautifulSunset
    ABeautifulSunset Member Posts: 600
    edited December 2015

    misstic, You do sound like the perfect candidate, and may have an easier time of it than I did.. Are you going to Dr. Khouri? Good luck snd please keep me posted.

    Ski queen, psychiologicslly it is SO important we keep our breasts. I know my doctor found fat in places you don't even think you have fat, so you may be ok. I'm not sure I would have someone do it who has never done that particular procedure before. Did he tell you he has never done a whole breast? I don't think there is a list but you can google whole breast autologous fat transfer with lipo, and you should find few doctors that way.

    Stefanie

  • ual0307
    ual0307 Member Posts: 12
    edited December 2015

    hi All

    I'm in the middle of the brava-aft process. Although I did a consult with Khouri, I chose a ps in Orlando. I had radiation after mastectomy so it took a great deal of time to heal skin and release scar.

    I chose ps because he does lipo once and then freezes fat for following procedures. So I'm up the next day. Was sore after lipo for awhile. So now the skin is stretching. I've done four procedures to heal skin, the next ones will be to create volume to match other side. I'm a small B.

    I too decided implants and flaps were not an option. Downside is that it's slow. Healing took a year...I hope to finish this year. Have to do a second lipo because I ran out of banked fat.

    It's a process.

  • ABeautifulSunset
    ABeautifulSunset Member Posts: 600
    edited December 2015

    I like that banking thefat stuff. Then you aren't sore everywhere after the procedure. Cool.

  • ual0307
    ual0307 Member Posts: 12
    edited December 2015

    I couldn't commit to the lipo every time. And it is fairly painful -- something that is seem to left out when it's called noninvasive!

    I do wish it was faster, but it seems there are multiple procedures for any type of recon that spans 12 or 18 months.

  • ABeautifulSunset
    ABeautifulSunset Member Posts: 600
    edited December 2015

    I agree. There is no easy easy way. Reconstruction is a process any way you look at it.

  • Misstic
    Misstic Member Posts: 50
    edited January 2016

    I saw my PS last evening. I am the perfect candidate for this procedure. In a first instance, he thought I was too thin to get a good result. But once I undressed completely, he admitted I have enough fat for the four procedures (I got 8 pounds just to be candidate to this surgery !). He showed me pictures of patients who got this kind of reconstruction. I was flying with the angels because of the magnificent results I saw.

    The remove of my implant and the fat grafting are to be held in february due to insurance problems I have to fix before.

    I will post after the first procedure to give a feedback.

  • ABeautifulSunset
    ABeautifulSunset Member Posts: 600
    edited January 2016

    Misstic, I dont want to bust your bubble, really I thought hard about posting this, but I wish somebody had been real and honest with me when I went into it, all optimistic. I think the pictures they show you are either soon after surgery, when you are still swollen and full looking, or woman who have had way more than four surgeries, or maybe there is a handful of cases that came out perfectly. I was expecting so much more than what I have, literally. After four surgeries, he ended up leaving one very small expander in each breast, because there wasn't enough fat to fill in the difference (because a lot doesn't hold). I'm about 8 months from my last surgery and they are basically shrinking. I"m down to a small B...with dents and dimples, and no cleavage. To make it worse, my radiated breast is hardening around the small expander and I'm having THAT problem again. Maybe one more surgery, or two would fix it, but I cant do any more. They were hard on my body and I've had a recurrence, so I think surgery is not a good idea now. This is not to say you will have the same experience as I. My wish for you is just that you are open minded to a less than perfect result. All of that said, they are still better than the large hard, cold mounds I started with.

    I'm sorry, don't be mad at me.

  • owlwatcher
    owlwatcher Member Posts: 63
    edited January 2016

    I too think the tricky part of fat graphing a whole breast is finding a ps that will do it and actually has experience in doing it outside florida. My cousins ps said he would do it then changed his mind. It is a very new procedure in reconstruction for many plastic surgeons.Of course they (docs)want to go with those reconstruction types they feel the most successful with.

  • meow13
    meow13 Member Posts: 1,363
    edited February 2018

    I should add that the fat grafting seemed to be more uncomfortable than my DIEP recovery wise. Fat taken from my thighs.

  • rk85
    rk85 Member Posts: 80
    edited January 2016

    I had both sides rebuilt with fat grafting with dr. K in miami in 2011/2012. I was a D before the reconstruction and he grafted me back to a D after 3 procedures. I think this happened because i didn't need rads, and he basically re-filled my breasts starting immediately at the time of bmx. They left the extra skin at the time of bmx, so I looked deflated untill the process was done, but since the skin was already there and didn't need to stretch out to accommodate the grafted fat he was able really put a lot in every time. Ive lost little or no fat (mostly this is not cause for celebration with all the other body parts) from the reconstruction in the last 4 years.

    Im not sure how he's doing it now but I wore the hugely cumbersome Brava before and after each procedure.

    Sorry to hear about your difficulties stefajoy, I know rads make things harder for reconstruction.

  • ABeautifulSunset
    ABeautifulSunset Member Posts: 600
    edited January 2016

    Yes rk. And he had to remove implants and heavy scarring, as well. I'm so happy you had a good experience.

    :

  • Adrielle
    Adrielle Member Posts: 5
    edited January 2016

    SkiQueen: I'm doing this now, bilateral. First round was about 2 months ago, and as PS predicted, about half of the transferred fat stayed put. This is not in Florida and not using any external suction devices. I had tissue expanders placed during original surgeries (cancer mx and then prophylactic mx on other side over a year later). Everybody's different when it comes to pain, but it was no big deal for me, no painkillers needed at all, and just avoided any heavy lifting or aggressive stretching for a few days, but otherwise normal activity.

    For the first round, he raided my middle-age tummy bulge and a little way over to each side of that. I expect 2-3 more rounds, and he'll be taking fat from various locations. I'd say I'm slender-to-medium weight -- not worried about fat shortage, but taking enough to replace both breasts will probably eradicate all my unwanted bulges. If you're very thin, that means more locations need to be used to harvest fat than if you were plumper, but I was pleasantly surprised how large an area he was able to harvest from with just one teeny incision on each side (closed with one stitch, and covered with a teeny round band-aid), and in your case you only need to harvest enough to rebuild one breast. Since you're aiming for an A size (that's my goal too), I think fat grafting is probably a good option for you.

    I don't want to give a lot more detail on the open forum, but if you PM me I'll be happy to answer your questions.

  • IzzyF
    IzzyF Member Posts: 5
    edited January 2016

    These posts are very helpful. I had immediate reconstruction with LD flap and implant one year ago. I'm hating the implant ... and today made arrangements with the ps to have it removed, probably in March, and do lipofilling instead. She said it would be two surgeries, 1 to remove the implant and do the initial lipofilling, and then four months later another lipofilling, nipple reconstruction (I hope), and matching the other breast. I'm rather slender but I don't mind being flattish. I just want the implant gone, and I want to see myself looking "normal" again.

  • letranger
    letranger Member Posts: 166
    edited January 2016

    thx for starting this thread. I had a BMX with TEs. After 6 months of my exchange surgery,I had an infection around my implant in my radiated site. So lostthe implant 1 year ago. Now I have one silicone and one large ugly crater. I recently talk to a PS and asked if he could do fat grafting. Even if to fill the indentation. He said he could create a new breast out of my belly skin and fat. No muscle cutting.

    Anyone heard of this or tried it?

    Once I get my cancer under control, I will look further into this as I will need to stop treatment for the surgery.

  • meow13
    meow13 Member Posts: 1,363
    edited February 2018

    letranger, that's what I had no muscle involved called DIEP, my skin color match is perfect.

  • letranger
    letranger Member Posts: 166
    edited January 2016

    Thanks, Meow. I am going to come back to this thread once I am in a position to get the procedure done. I'm still in treatment and will have to stop tx to do the reconstruction. I thought a DIEP involved muscle grafting which I am not willing to do. How successful is fat grafting a full breast on radiated tissue?

  • meow13
    meow13 Member Posts: 1,363
    edited February 2018

    I wish my friend was on this site. She had a mastectomy and radiation and didn't do reconstruction until after she saw my DIEP results. Eleven years no reconstruction she did the DIEP. It went great she had fat grafting too. All plastic surgeons say they hate dealing with radiated tissue but I know 2 radiated women that had DIEP and it turned out great. I need to mention that Brenda's nipple reconstruction was a failure mine was not but the tattoo disappeared. My other friend had the DIEP and no nipple reconstruction she looks wonderful.

  • Beblev
    Beblev Member Posts: 1
    edited February 2016

    Thanks for starting this topic. After weighing all my options, I have decided that fat grafting is the best for me because 1., I was flat-chested before my double mastectomy so I'm only aiming for an A-B cup, and 2., I have had some movement issues with all my scar tissue (and have done a lot of PT for it), so don't want to add another (reconstruction) surgery. However, my concern is that both breast areas were radiated after surgery and I understand that a lot of PS won't attempt BRAVA/fat grafting after this. I would like to find a PS locally who is confident about doing this, but I'm not sure how to go about the search. I realize that Dr. K. in Miami is probably the expert in this field, but getting to Miami several times a year and staying there to recover would be a financial hardship for me. Does anyone know of a PS near Maryland who does this? I'm willing to travel to nearby states as well.

  • ABeautifulSunset
    ABeautifulSunset Member Posts: 600
    edited February 2016

    I myself went to Miami, butthere is a dr Christina Ahn in NYC who is supposedly on par with dr. Khouri.

  • Misstic
    Misstic Member Posts: 50
    edited February 2016

    I had my implant removal and first fat grafting yesterday. For the moment I am in pain as expected. I have an appointement next monday to take off the dressing and see the result. I got 250cc of fat for this first step. My natural breast (right one) is 500cc so the PS expects 3 surgeries, this one inluded.

  • Misstic
    Misstic Member Posts: 50
    edited January 2017

    One year later, here is my journey ; i had the 3 surgeries ans the result is... amazing ! My surgeon always told me I was a good candidate for this procedure for 2 reasons : first, I had a nipple and skin sparing mastectomy with immediate reconstruction (silicon implant which gave me a lot of pain and nodes problems) so my skin was ok for fat expanding (no BRAVA needed). Second, I hadn't any radiation. My surgeon never perfoms this surgery on women who had previous radiation because the expected result is not as good as with a healthy skin.

    What I have today: my lost boob is like resurected. It has nothing to do with an implant. The touch and the look are like a natural breast (when you lean forward, the boobs have the same shape for example). An unexpeted effect for this procedure : the nerves in the skin of my breast are growing back. Sensations in the breast are not like in the natural one but there is definitly more sensations than before the surgeries. My surgeon explanation : nerves are made of fat so the neuronal stem cells are helped.

    My advice to women who want to do this reconstruction: you have to be very motivated (3 surgeries and pain of the lipposuctions) and find an honest surgeon to tell you if you are or not candidate for this procedure (the result depends a lot of the quality of the skin, for the boob and the donor sites).

  • ABeautifulSunset
    ABeautifulSunset Member Posts: 600
    edited January 2017

    Misstic, I am so happy it turned out well!

    My right breast fat graft is really nice, like yours. But my left, radiated breast still has issues. I think I could actually get a better result with one more surgery....but I m not ready for that yet.

    Stefanie

  • Misstic
    Misstic Member Posts: 50
    edited January 2017

    I'm so happy for your right breast too Stefajoy.

    I will pray for your radiated boob. May it turn as well as the right one. Keep us posted when you will be ready.