Fat Grafting, pros and cons

Smarrty, i have a shelf on both foobs. Noticeable without a bra. DBF doesn't care-THANK OMD for that. I am conscious of it. Whatever your decision on a fix.  Suggest contact with SpecialK

BTW you look fabulous on the pic on the other thread. Totally jealous of your curves i.e all in the right places.  Lookin good gal!

I had fat grafting in July to top area of breast after partial mastectomy and radiation 9 yrs ago. I was so excited and optimistic but it failed...prob due to poor blood supply in radiated tissue. Am going for another go next month. Fingers crossed. Some women seem to get excellent results. If not will consider LD flap altho that is mega scary as risk of creating problems just for aesthetics of having 2 boobs the similar size. So helpful reading all the threads and posts. Just to add.....the fat grafting procedure was under GA and except for some bruising from the lipo.....easy recovery....altho' the anaesthetic made me feel like I had alzheimers for about a month after which was actually quite scary! As results with fat grafting seem to be so variable you have to be open minded and be prepared for 'the journey'. What a bugger radiated tissue is. Annoying that I recall no discussion or information about the impacts of radiation on future reconstruction at the time of diagnosis.  Mind you....when you are just dealing with the ca diagnosis It's not easy to process all the other stuff. Looking forward positively and feel very lucky to be offered reconstruction on the Public System (NZ) after 9yrs. Interestingly no doctor even mentioned the topic until I asked about it! 

Jane, my fat came from a variety of areas since my PS stages things.  First from the flanks (back above waist), then outer thighs, and inner thighs.  Last little bit came from just above the hips in the front.

Thanks MartyJ and Lily55!  I'd love PS to take some from my flanks/back and so I will have to discuss with him. 

Lilly55- I've heard the same thing with PS' not wanting to turn you back and forth but you would think they would do so for a preferred cosmetic outcome. 

Have you both been happy with FG result?  What is a reasonable amount of thickness to expect with the FG?  For example, can they build up upper pole to an inch or more?  I understand 40 percent may be lost over time but was wondering whether it is possible to just get a thin layer of fat or a thicker layer that fills more than divots and alters shape. 

Boston:

Fat grafting is actually often used in radiation patients before implants are placed, as there is some evidence that it improves outcomes for radiation patients who have much higher failure rates when it comes to implants. I am curious as to your statement that gauze caused divots though? That would have to be some awfully strong, and long-adhered gauze! And since you just had exchange in August, it seems like, as with most divots and ripples, it is a result more of thin tissues....fat grafting is sometimes used to try and thicken up this tissue to hide rippling and other contour deformities.

As mentioned above, fat grafting does not always take (and even where it does, some may lose 40-50% of it), so sometimes yes it needs to be added too. It will not look unnatural though, as it is kind of "liquified" and injected to smooth out areas. It is possible to develop areas of fat necrosis, like hard lumps of fat, but these are not harmful and sometimes dissolve on their own in time.

My FG experience was much like Claire's - I had divots above my implants in the upper pole, and a fairly bony chest.  I had excellent results, and the FG made things look much more natural.  I had little to no reabsorption of the fat and would have needed only one FG.  My post-surgical experience was very good, minimal soreness.  The biggest issue was having to wear compression garments for 8 weeks, 24 hours a day, and a restriction on exercise - I was allowed to walk only, no gym.

Hello- I had fat grafting about 2 weeks ago on 9/11...my PS  took fat from the saddlebag area and the back of hips-love handles. I am a unilateral but he also put some fat on my native breast as well. The brusing on my legs was fierce and painful, but I used Arniflora (arnica gel) several times a day as well as taking emergen-c and now I have about 15% of the bruising left on my legs. Oh and the bruising travels down to the knees as it heals.

They can put fat anywhere- for the bottom edge they would just move the implant out of the way to put the fat in-they are sculptors. I have holes all over the place from where they took fat out and fat in. I have 11 holes fom the cannulas (donor and transfer sites) and I also have lots of little needle marks on the donor areas- I am  assuming to even me out and leave a nice contour...will have to ask PS at my 3 week follow up.

As of now- I have a natural upper pole slope that matches my native breast and the rippling is gone. For a unilateral I have a nicely matched pair of breasts. My PS said preop that he only needed 100-150cc of fat to transfer. They used to require compression garments but  stopped as it was hard to fit due to individualized post lipo swelling etc. Kinda like the lymphadema sleeves-a wrong fit is worse than no garment. So I haven't had to wear one, but I have been wearing a spanx that doesn't fit too crazy tight for a couple of hours a few times a weeks starting after my one week post op.

Also besides surgical technique, the survivial of the grafted fat depends on angiogenisis- create new blood vessels-so the fat can survive. So all of the anti angiogenic foods that help retard the growth of cancer can inhibit the "take" of the fat transfered. So no green tea, broccoli sprouts, artichokes, etc etc a list of 40 antiangeogenic foods to avoid .for a bit. It's also recommended to keep insulin higher (feeds fat) so I am eating additonal pieces of fruit and a few more (non gluten) carbs. I also have been eating grass fed butter, grass fed cream, almonds, pepitas, range eggs/chicken etc etc  in moderation along with lots of carrot juice, water, decaf coffee, etc....of course all organic. All to help me retain the fat and heal quickly. Also alcohol can cause angiogenisis-but red wine is an anti angeogenic. I was taking vitamins sourced from foods -many if not most antiangeogenic (Seeking Health- Optimal Multivitamin),  but now just taking Now Multi Vit for the next couple of weeks. I have also read that the older you are the lower percentage of fat takes

One more thing- I asked my surgeon for a list of plastic surgeons for fat transfer (post breast reconstruction) and they gave me a list of 4 and I asked who did the most fat transfer procedures and I went  with the surgeon who had done the most.

So far the only lumps I have are under my armpit scars where some fat was put in to level them out-surgeon said to massage them daily-so far it has helped to soften them so I will continue to do daily massage.

Since this was my 5th surgery in less than 2 yrs due to cancer/recon, I decided to do a little something for myself and had just a little  fat put into my upper lip to get rid of the vertical lines. I looked like a smurf last week, but it has settled down. It is still a bit swollen, but will settle soon. I figured why not since they are harvesting fat anyway, and it lasts much much longer than injectables. 

Will keep you updated as to what percent took and results....they say Iit can take months and months to see final results...

Hmm, am considering fat grafting in a few months if my implants don't even out. My PS used two different sizes and we figured they would drop and be similar in size appearance wise. They are but the difference is the upper poles. One breast sticks out above a bra and the other does not so it's pretty obvious. I can probably live with that but if fat grafting can fix it why not? I do worry about more lumps and biopsies, oh my I don't want to go through THAT again. PLUS my Vinnies will have to wait until 6 months after fat grafting. 

My PS said no compression garments or restrictions and I hope that holds true.

bobo - I have an upcoming appt with my PS to set the first surgery - should be mid-Oct.  My PS is pretty restrictive on the compression and exercise, but having done this once before and seen the donor site result, I will follow his instructions.  It is just that Spanx and pajamas is such a weird combo, lol!  I am in better physical shape for these upcoming FG surgeries than I was for the first one.  Here is a list of anti-angiogenesis foods, so I assume these would be foods to avoid in the short term.  I had been following this from an anti-cancer perspective, but will slow down on it:

http://blog.ted.com/2010/02/10/dr_william_lis/

How are you doing?  I like the step-down approach of your doc, still a long time but not at 24 hours a day.  I took some very long showers as that was the only time I was not in compression!  My PS was mostly concerned about fluid accumulation in the tunnels created by the cannula, and a resulting seroma.

Um.  OMG.  That list is, like, everything I eat.  What will I eat now?  Yikes!

I am told I had excellent retention as well.  It's just strange since I have this smoothie recipe from another PS (not mine, he would never deign to give out smoothie recipes) that contains many of the foods on that list.  But that smoothie is for healing and immunity, not fat retention.

I hesitate to do things to get fatter (i.e., eat more high-fat foods) since I am already feeling so out of shape!  What I eat a lot:  nutmeg, green tea, dark chocolate, kale, turmeric... lots of what's on the list!  

I only like pineapple when it is room temperature.

You don't know the half of it.  My DLLP is a saint.

p.s.  I am putting things in my amazon queue with which to possibly treat myself when I am stoned on pain meds!  Granted, they are useful things, like China gel, so it is not excessive.  But sometimes I feel anything I do not buy for the eight-year-olds is a splurge:)

Great info on FG - had my consult about a month ago and meeting with PS again on October 14 to lay everything our for a November procedure.  Thanks so much for sharing your experiences with FG - I have lost a lot of volume on the left and hope that it can be filled in and then some shaping done!  MAM MIA! 

I really struggled with my decision to have a bilateral revision with fat grafting back in June of this year.  But looking back, it was one of the best decisions I've ever made.  I was a little leery of the FG procedure but both my PS and whippetmom are huge proponents, so I decided to give it a try.  (Heck, I was already going to be out.)  I was warned that as much as 50% can be reabsorbed into your body, but I was lucky and had a really good result with the little amount that he used and it's stayed pretty much intact for the last four months.  However, as the implants dropped a little and the swelling went down, I have a distinctive crease across the inferior medial quadrant that is now quite apparent. I'm not wild about going under anesthesia again (is anybody?), but I'm going to do it one more time so my PS can do a substantial amount of FG to plump up my skin above and between the implants.  

The first time I woke up to find two stitches in my belly button.  I was sore - like I'd done way too many sit ups - for a couple of days.  The bruising takes the longest to go away, but then I didn't really have a lot of that either.  This time, I expect to be really sore for a few days and a lot more bruised.  I had my pre-op yesterday and my PS said he's like me to wear some kind of compression garment for about a month because he's going to harvest from the flank area this time.  I'll let you all know how it goes...