Fat grafting for reconstruction after implant loss
Hi, I am looking to find more recent experience of fat grafting for reconstruction. ie using only liposuction obtained fat, not the DIEP procedure. My surgeon has suggested this for me. It would result in a very small cup, possibly further procedures to "top up" with. He mentioned downtime and pain was "minimal". I was wondering if that is everyone's experience, is it becoming more common now it is 2023 and how the results were for those that had this done? Also for those that had it done sometime ago, how the long term outcome has been? I did not have to have radiation. Thanks
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Hi @abby001 and welcome to our BCO Community!
Hoping you hear from others here. You may also want to use our Search to find other discussions on this as well.
And here's also a link to our section on Fat Grafting, if you haven't checked it out
We're here for you, and happy you found us!
Warmly, The Mods 🤗0 -
Hi @abby001 -
I'm not quite the experience you are looking for….but close.
I had a mastectomy with immediate lat flap. Usually, a lat flap isn't enough to give you very much for a breast, so an implant is added to it. In my case, I didn't want an implant. So, 6 months later, I had fat grafting done where they took fat from other parts of my body and used it to 'make' a breast. For me, the lat flap served as a 'base' for the breast, so your procedure is a bit different as it sounds like it is strictly fat grafting. My other breast is from a tram flap and is about a small C cup. The fat grafting added to the lat flap and now 5 months later, I have about an A or possibly small B breast. (It did go down in size somewhat since the surgery.) I will tell you that the grafting surgery was not a big deal. However, it was more than I expected and since I bruise easily anyway, I was bruised all over my body. Apparently, bruises on your legs can even spread downward (gravity), so my bruises went all the way to my ankles even though the fat taken was from my thighs. I guess sometimes even your feet can bruise. The pain wasn't that bad though, it was pain like from bruises as opposed to pain from incisions. I only took maybe 1 pain pill and I did travel internationally about a month after my surgery. I'm retired, but could have gone to work within a day or so. I am going to have another surgery in the Spring to 'top up' as you say, and try and make them a little closer to even. He did tell me I don't have a lot of fat available and he might not be able to get them even. (This seems surprising to me as I am not really a small person.)
Anyway, I'm happy that I did this procedure-even if it doesn't end up even, but for me, the only other choice was an implant and I really didn't want an implant.
Fat grafting is a newish procedure, so you may not get too many responses. It sounds like it is done fairly often to 'even things out' from a Diep or implant reconstruction, but I haven't seem many posts about doing it completely as a fat graft. Maybe your ps could give you a reference to talk to their patients who have had this done? Most important is to have a a ps who knows what they are doing….
Good luck to you!
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Hi mandy23,
Thanks for sharing your experience. That is very helpful.
this PS seems to have experience with this and was recommended to me by my oncologist as know for his expertise. They are working on gathering some picture of other patients that had a similar procedure to give me a better idea.
I am also interested to hear about people’s experiences with liposuction in general and flying afterwards
Thanks again and good luck to you too.
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I had fat grafting twice to address some symmetry issues after DIEP (one a year after original BMX with immediate DIEP recon a, the other around 6 months after that). My PS said before my first graft to figure I’d retain around 50% of the transferred fat at the breast site.and rest would be reabsorbed into my body. That turned out to e the case. Fat was taken from my flanks, I used arnica on the bruising and was able to resume remote work the next day. Could have gone to office the day after but would have had some discomfort. Ibuprofen plus acetaminophen/paracetamol was sufficient for the pain level.
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I'm a little jealous - I floated the idea of removing my implants and only doing fat grafting, and my PS said it would probably take a bunch of procedures (I think his guess was 12?) to make any kind of shape. I did have fat grafting once, and the procedure wasn't bad at all. I'm currently scheduled for a DIEP next month, and I expect I'll do fat grafting again at some point.
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I had a unilateral mastectomy 6 years ago, followed by reconstruction with an implant. I am only an A cup, so they used the smallest one available. The implant ruptured, and I am having it removed next week. I have disliked the implant - it has never felt very comfortable. So, instead of another implant, the PS is going to use liposuction to harvest my own fat. I am athletic and relatively slender (BMI of just under 20). The PS said she would probably get the most fat from my inner thighs. She also said it may take 2 procedures. We'll see how it turns out.
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Hi @xxxgggyyy. I hope all goes well with your surgery next week and that you are way more comfortable with the results this time!
I just had my implant put in and some fat grafting done around it. So far the implant is a vast improvement over the tissue expander! I’m really hoping it’s comfortable enough long term. Fat grafting instead of an implant is fascinating! It’s amazing what can be done for reconstruction.
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Hi lovefood. I had the first fat graft procedure done in July. Since I had lost so much weight after the cancer diagnosis they were only able to harvest 80ml from my tummy. Still, they used it to make a "base" as the surgeon called it. So my chest is now flat looking rather than the uneven, ribby way it looked before. It is September now and I haven't noticed much resorption at all. (They told me up to 40%). Within a week after surgery I got back normal sensation on one side and the other side was improved. I was surprised by that but my surgeon said he had heard that from others too. My lymphema and cording flared up a bit too but It settled down with time and exercises. The skin feels and looks better too, not so thin as it was. I am having a second procedure done in November (I didn't have to wait that long, but needed to for other reasons). This might be the last one or there might be a third. This time he will take from thighs, which is meant to be more uncomfortable, but I should get some actual cup after that (probably only a small A). I'm happy with the outcome. The procedure itself was not too bad. I basically felt badly bruised but I didn't need to take any painkillers after the anesthetic wore off. The bruising pain lasted for a couple weeks (everywhere the blood settled felt bruised, not just where the liposuction was done) and it has taken until about a month ago (approximately 2 months) to see the full effects where the liposuction was done (tummy). From what I understand this is getting more attention and more people are getting it done. I don't know why my initial plastic surgeon didn't mention it and denied it could be done when I asked, but I get the impression that the change in size is not as drastic as implants would be.
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Hi @abby001 thanks so much for your feedback. I saw my surgeon today and mentioned fat grafting he denied me. He asked me to wait a couple of months to see the implant result before discussing other things. But I feel like he does not wanted to do another or more surgeries. He said fat grafting is going to be very small breast and he’s going to cut skins. Did you have implants before? For the fat grafting procedure, did they put an expander or just cut the skins?
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Hi again. My situation was that I lost my implants to infection 3 weeks after my mastectomy. When they removed them they preserved the skin in case I wanted to pursue reconstruction which I wasn't sure about at the time. I decided I did not want to go the implant route again and go through the chance of infection and long healing all over again and so I asked about fat grafting instead. My first plastic surgeon and the one he referred me to said it wasn't possible. So I asked my oncologist if they had any recommendations of other plastic surgeons I could consult with for a second opinion and this is how I found this PS, based on my oncologists recommendation. It make sense if you have implants that you would need wait for it all to heal, before more surgery, but I have a number of friends who had a small amount of fat grafting to even up the implant result. See above also. When you say cut skins do you mean make an incision? The PS that did the fat grafting for me made 2 x 1/4" incisions near my hips to harvest the fat and injected the fat into my chest area with a largish needle that resulted in approximately 1/4" incision into the edge of my mastectomy scars. So not much cutting. There were no expanders beforehand either. So healing and rest was much less than for the mastectomy/implants. It checked all the boxes for what I was looking for (some shape but minimal trauma and low chance of complications) so it seemed like a good compromise for me.
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