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Fat grafting for reconstruction after implant loss

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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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  • moderators
    moderators Posts: 8,287
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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 https://www.breastcancer.org/treatment/surgery/breast-reconstruction/types/autologous-flap/fat-grafting

    We're here for you, and happy you found us!
    Warmly, The Mods 🤗

  • mandy23
    mandy23 Member Posts: 113
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    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!

  • abby001
    abby001 Member Posts: 2
    edited December 2023
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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.

  • abigailj
    abigailj Member Posts: 104
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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.

  • nns121317
    nns121317 Member Posts: 116
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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.

  • xxxgggyyy
    xxxgggyyy Member Posts: 21
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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.

  • needs.a.nap
    needs.a.nap Member Posts: 195
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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.