autologous fat transfer - poor result
last week I had liposuction and fat transferred to the breast area where I had a mastectomy. I also had a lift and reduction on the other side. I was a D on that side and now it's probably a small B.
The fat transfer doesn't show any noticeable increase in the volume of the breast. I understand there are limits to what the doctor can do and that some of the fat is likely to dissipate in time. but there seems to be no result from this painful procedure.
I have a post surgery visit scheduled but when I confirmed I found it it is with a nurse. I've asked if I can get an appointment with the doctor. I'd like to talk to him about this. I expect he will say something like I tried but this is what we got.
I understand a lot of women who do this procedure do multiple injections. So is this normal - to basically see no improvement after one fat injection?
I'm glad I had the lift as at least I have something to show for the pain and inconvenience. Now if I do nothing more I will have a skin mound and a small breast rather than a skin mound and a large saggy one.
thanks for any advice
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@mary9999, it may be too soon to see noticeable results, especially as you may still be experiencing swelling from your surgery last week. Are you wearing any compression garments? Compression garments are often recommended for at least a few weeks post-surgery and fat-grafting, and the stability from that compression plus this recovery time period is also needed to allow the transferred fat to "take". After several weeks' time, your team can then assess the results.
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I hope you're right but I saw a nurse today for post op visit. she said it won't get bigger. and my understanding is that if anything the fat dissipates
Nurse had no explanation for the lack of a difference in the "breast"…..I asked where the fat went
Yes I have to wear a compression garment and bra 24/7 for 6 weeks
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Please allow your body some time to recover, and see how things are after 6 weeks, @mary9999! A single session of fat-grafting will typically provide subtle results. It will not offer significant volume increases in breast size, however it should offer visible improvement in the appearance of ripples or divots, and should help soften the appearance of the post-mastectomy reconstructed breast. Typically patients report noticing a gradual dissipation of about half of the fat transferred, in which case repeat fat-grafting sessions may be needed.
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thank you
I don't have an implant….the fat is the only reconstruction I have. and the lift and reduction on the surviving breast.
I didn't expect an excellent result with one fat transfer but I did hope to see something.
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Hi @mary9999 -
Sorry your procedure didn't go as hoped.
My situation was slightly different, but since you haven't gotten many replies, I thought I would respond.
My latest mastectomy was with a lat flap. The lat flap is usually done with an implant. However, I didn't want an implant. So, my ps recommended the lat flap with fat transfer. Just doing the fat transfer without either a lat flap or an implant (as you have had) is a newer procedure. I've heard of it, but it is pretty rare. Actually, I haven't heard of anyone doing the procedure I had done either.
In my case, I had the lat flap at the same time as my mx. This did not include any fat transfer and was more to build the 'base'. I had 2 more surgeries that did the fat transfer. The first one added some depth to the breast, but I felt I really wanted the 2nd additional surgery to add to it. I think it is slightly smaller than the other breast which was a tram flap from an earlier dx. However, I am now happy with it as it is.
In your case, (I'm just guessing here), it almost seems like the surgery you had would have been more to build the 'base'. My guess is you would need additional surgeries to build that up. How many surgeries did your ps indicate you would need when you had the initial consultation? If I were you, I would also want to discuss it with the ps . Will they allow you to make an appointment directly with the ps? Did the nurse recommend future procedures or what?
Sorry this has been such a frustrating experience for you. It is a lot to go through if you aren't seeing the results you expect.
Best of luck as you pursue this.
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I asked for the post op appointment to be with the doctor rather than a nurse but they didn't have a time available that was convenient for me so I saw the nurse. she really didn't have any answer as to why my result was what it was. not surprising since she works for the doctor. she isn't going to criticize him.
What the doctor said at my initial visit with him was he would do the tissue expander at the time of the mastectomy. then a couple of months later do an implant with fat transfer to give better result. but he wasn't able to do the tissue expander, I guess because of my circulation being inadequate.
so at subsequent office visits he said if I waited long enough he could do implant or fat injection without tissue expander. I wanted to avoid the tissue expander as I had heard it was uncomfortable.
He was somewhat inconsistent in what he said but I guess I hung onto him saying he could maybe get me to a small B with just the fat transfer.
I asked the nurse what she thought about more surgery. She said the thought I could get a good result with just an implant - no more fat injection. She said if she had to make this decision and she didn't want an implant she would go flat.
When I had asked him right before this last surgery what result he could get with just an implant he said it would be ripply. So I will see him in a couple of weeks. If he says the fat didn't take and and implant would still result in ripples, I'm done. If he says he can match the lifted breast with just an implant and recovery from that would be easy I may consider it.
I have a feeling he is done with me. and I'm done with the pain and inconvenience. I'm 74 - how vain do I need to be? With the way I dress, a prosthetic partial breast form will look fine in clothes.
thank you for talking to me. I appreciate it.
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Hi @mary9999
It's always a lot of decisions isn't it? It sounds like you have your head around your options and that's really the most important thing. Treatment and recon after dx is one time when you can truly say "It's ALL about ME!" because it really is. As long as you feel good (or accepting) about things, that's all that counts.
Your other option is another opinion, but it sounds like you have had about enough and I can certainly understand that.
Take care.
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@mandy23 I haven't gone through as much as you have but it feels like a lot. as of yesterday I discovered some blood apparently oozing from my incision onto my bra. doctor said I should buy some meds and apply with gauze. It's not much blood but of course an infection is the last thing I need.
Hopefully drain is coming off tuesday. that will release me from prison of not driving and not wanting to be seen in public wearing it.
I have thought about a second opinion but the doctor I'd want to go to is very busy and his office is pretty far from me.
I'd ask my breast surgeon who did the mastectomy for another name but she likes the one I have and she never answers her own messages. I always hear from her nurse.
thanks for your thoughtful advice
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@mandy23 finally after about eight weeks the incision below my lifted and reduced breast has closed. I saw the nurse at my plastic surgeon's office yesterday. she said it looks great and I can stop using ointment and gauze. I have an appointment with the doctor in a few weeks. I don't think I want any more reconstruction. I'm tired of feeling numb, stiff, pain. I can go talk to him. He will probably say if I want, he can do an implant with more fat injection to make it look better. I'm tempted to just cancel the appointment. He may say I've been through enough but if he suggests more surgery it may confuse me.
He isn't pushy or salesy but it's his job to do these things and he has a tendency to minimize the potential risks - like implants needing to be removed.
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Hi @mary9999
Really sorry to hear about your issues with your incision. I missed your post from 2/22. I think I was traveling at the time, so I didn't see it. What a pain that must have been! I'm glad to hear that it has closed and has healed.
You have been through a lot. As you stated earlier, it might be time to just be done. I'd say hold the appointment for now and just think on it for a few days. Now that you are healed, if you are comfortable where you are at, then cancel in a few days. It's always an option to change your mind later too if you find you don't like where you are at. If that happens, you might want to find a different ps as it does sound like there was some communication lacking on his part.
Sorry for all that you have been through. Maybe it's time to put it all in the rear-view mirror and enjoy life, for as we all know so well, each day is a gift.
Best of luck to you. 😊
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