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Was fat grafting worth it?

Hello, seeking feedback from those who had fat grafting with their exchange from TEs to implants. All input appreciated, with particular interest in results on those carrying a moderate/lower amount of fat. Was the resultant appearance of your breasts worth the extra procedure and recovery? How did the sites from which the fat was taken look afterwards? Anyone have grafts primarily from their sides vs front of abdomen? If so, any issues with asymmetry or odd contours? Feels a bit frivolous to be a concern amid everything, but might as well try for the best-possible experience and outcome. Thank you.

Comments

  • nns121317
    nns121317 Member Posts: 110

    I had a direct to implant reconstruction, so no TEs, then had fat grafting about 18 months later (after chemo/rads). For me, the fat grafting was worth it. More natural appearance up top, and they used my love handles/flanks because I wanted to preserve my abdominal fat for a possible DIEP. I did end up doing the DIEP because implants weren't for me, and I am considering doing fat grafting again depending on how my DIEP looks (just had it done 2/20). My surgeon, whom I adore, made things very equal during fat grafting - no issues with contours or divots.

  • wishinguswell
    wishinguswell Member Posts: 6

    @nns121317 Thank you very much for sharing your experience and addressing my questions—extremely helpful! Wishing you the best with your DIEP recovery and outcome.

  • needs.a.nap
    needs.a.nap Member Posts: 157

    Hello @wishinguswell. I read your post the night before I was to have my exchange surgery with fat grafting and a reduction of my other side (my surgery was yesterday) and all I could think was, Wow! These are great questions to ask, I wish I had thought to ask them. I can’t provide any answers because everything is too soon to tell, but I went ahead with the fat grafting. I understand how it feels almost frivolous! And it does add a little more to the healing process which I struggled to justify but I reasoned that it’s one surgery, one recovery, and if I didn’t do it now, I don’t know if I ever would. My surgeon used my “love handles” and I’m now in a tight binder. I took pain meds last night and just did Tylenol and Advil during the day. If I sat still I felt fine but moving around is pretty tender. I haven’t looked at myself in a mirror yet, I’m not ready.

  • wishinguswell
    wishinguswell Member Posts: 6

    @needs.a.nap Thanks so much for taking the time to reply right after your surgery. I hope your recovery goes well and I’m glad you’ve been able to manage your pain. I think I’m going to go ahead with the love-handle grafting with a similar mindset to yours: go for the best long-term outcome in one shot despite the extra healing. If you are so inclined, I would love to hear how you progress. I hear to expect pretty significant bruising and that pineapple and arnica may help. I’m scheduled for exchange in a few weeks. Kinda can’t wait; also kinda sighing as I’m finally unrestricted again physically with full range of motion and thinking about needing to re-rehab everything.

  • needs.a.nap
    needs.a.nap Member Posts: 157

    Hi @wishinguswell. Those were my exact feelings … I was finally feeling almost normal again and able to use my arm mostly without pain … I was having some annoying shoulder issues in recent weeks and a little restriction that might have been from cording that was persisting in my chest. But the thought of having to be limited for several weeks again was making me second guess my decision to even have this surgery. I was stressing over if it would make my shoulder issue worse (I tried getting in to physical therapy but the earliest available appointment was around the same time as my scheduled surgery) so I’ve got PT lined up for next month and some massage therapy with a lymphatic massage therapist lined up for May. I’m determined to get back to as normal as I possibly can since it’s my dominant side and I do very physical work (gardening) and I’d like to be able to work this growing season. Sorry for all this detail. Just that I can relate to your apprehension.

    Interestingly enough, my arm and shoulder feel fine. Is it from taking pain relievers? Or limiting my motion? I’m curious if the surgeon was able to remove or break up some of the scar tissue and cording. It sounded like he was going to.

    I’m feeling pretty good today, I think the residual effects of anesthesia have worn off and I took the Norco pain meds in the night again but am just doing Tylenol and Advil during the day today. It’s uncomfortable but I’ve had way worse pain with other things so it’s fine. In fact, the pain is helping me remember to not use my arms too vigorously so that’s good in a way.

    So far, from what I’ve looked at, the bruising isn’t too hideous. I have one area that I think is a hematoma (it’s deep purple and is extra tender) … I had one from my biopsy that turned 2/3rds of my breast purple and it was super tender for a while so I’m not freaking out over this one. I do have pineapple and arnica so I’m trying that.

    I think at the moment, I’m glad we did the fat grafting. I can see that it has given a softer look to the implant instead of the weird hollowed out space I had above my tissue expander. I won’t particularly miss my love handles either. But I’m not sure how keen I’d be to doing any more fat grafting down the road (between paying a high deductible and subjecting myself to an additional surgery) … so we shall see what I look like once swelling subsides and the incisions heal.

    I never would have imagined I’d be discussing this, or having any of this … it’s still so surreal, that I had cancer! I’ll try to keep you updated and feel free to ask me specific questions (you could always private message me). Take care of yourself and try boosting your body before your surgery if you can (getting well hydrated is a big one)!

  • wishinguswell
    wishinguswell Member Posts: 6

    @needs.a.nap - I’ve had cording issues, too, both arm and trunk. So glad I asked for PT and really lucked out getting in right away. Huge difference quickly in my range of motion and comfort. Lymphatic massage is the BEST. I’m hoping I can start up again with at least that part of PT ASAP after the exchange.

    Hope that if it is a hematoma that it resolves quickly. I have not had that thus far, knock on wood. I had my TEs placed after the mastectomy (skin issues) and I was thinking maybe they used some Alloderm to fill the part that looked kicked in under my clavicle on one side because it looked a lot better after TE placement; I forgot to ask about that.


    I really hope the grafting turns out well worth it for you (and for me)! I so hear you about the weirdness of all this, so thanks for the weirdly lovely conversation, lol, and looking forward to updates. I’ll let you know how I move forward, too

  • mtks
    mtks Member Posts: 61

    I had a DIEP flap after explant. My breast area looks like the flap reconstructed the lower half only. Is this how most look?I haven’t seen my PS yet but I was expecting more of a full breast.