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Topic: Implant surgery/liposuction

Forum: Breast Reconstruction —

If you've had or will be having a mastectomy (or in some cases, lumpectomy), you're likely facing decisions about whether or not to have breast reconstruction, and if so, what type and when. Deciding whether or not to have a breast reconstructed is a very personal choice. Take the time you need to learn about how breast reconstruction might affect you, both emotionally and physically, before you decide to have the surgery.

Learn about different surgical options and the medical and personal issues around breast reconstruction.

Intro medically reviewed by: Brian Wojciechowski, M.D.
Last review date: November 22, 2020

Posted on: Mar 5, 2021 03:35PM

kmldpl wrote:

I went to see my plastic surgeon this week for my last "fill" and we were discussing the implant surgery. And she mentioned that she would be doing liposuction because the fat would help my implants stay in place. But I have no desire to have liposuction! Has anyone else heard of this? Don't most people have their implants without liposuction? Thank you for you thoughts.

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Mar 5, 2021 05:36PM - edited Mar 5, 2021 05:43PM by DiveCat

If you do searches for fat grafting here you will find a lot more about this. It is actually very common these days to soften out areas over implants and lessen rippling or other cosmetic issues that arise from implants after mastectomy. It's often also used for radiated breasts to improve the tissues so they are better able to accept an implant. They basically take some fat (usually not a whole lot) from areas like tummy, thighs, sometimes buttocks, run it through a machine to separate the good fat out and place it in places of breast where there may be benefits.

My own PS prefers to wait a few months after putting implants in (even with an exchange) before doing fat grafting though, to see how things settle out and where the concerning areas are. He also finds better uptake with a gap to let body recover from first trauma

I just had my second fat grafting yesterday (both times fat was taken from my tummy/midsection, which was my preference as my sister had a painful experience with it from her thighs and thighs are a bit harder to keep smooth if you are thinner). Surgery itself was not long and while I had to stay around a little longer on day surgery unit as one of my tummy incisions kept leaking on me a lot I went home of course same day. Taking it easy today but feel pretty good and like last time expect to go back to work next week (I did work from home a bit today).

You certainly don't HAVE to have it, it is your body, and you also don't have to do it at same time. You can wait and see how you like the implants after the initial swap and they have time to settle in. Everybody and every body is different. I have thin skin and my surgeon was aggressive at removing breast tissue so the rippling for me was not satisfactory hence going in for fat grafting. I needed two rounds (hopefully only two, not planning on more) but my sister stopped at one as she did not want to go through more surgery. Too early to tell how things will take as there is still some swelling but my PS appears to have tackled the areas I was concerned about.

Hereditary High Risk, Uninformed BRCA Negative Surgery 4/24/2014 Prophylactic mastectomy: Left, Right; Reconstruction (left): Silicone implant; Reconstruction (right): Silicone implant Surgery 3/12/2015 Reconstruction (left): Silicone implant; Reconstruction (right): Silicone implant Surgery 11/14/2019 Reconstruction (left): Silicone implant; Reconstruction (right): Silicone implant Surgery 7/9/2020 Reconstruction (left): Fat grafting; Reconstruction (right): Fat grafting Surgery 12/11/2020 Reconstruction (left): Nipple tattoo; Reconstruction (right): Nipple tattoo Surgery 3/4/2021 Reconstruction (left): Fat grafting; Reconstruction (right): Fat grafting
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Mar 6, 2021 12:40PM JanetM wrote:

Glad you are recovering well. I am having fat grafting done on 3/26 also due to thin skin and aggressive removal of breast tissue complicated by failed DIEP flap. This is being done even before any fills to the expanders. What kind if compression garments did you wear and for how long? Hope your recovery continues so well

DCIS 10/2020 Bilateral Mastectomy Lumpectomy 5/24/11 - LCIS, ALH and ADH and SAH/BSO - 8/10/11 Dx 5/25/2011, LCIS, Left, 0/0 nodes
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Mar 6, 2021 12:44PM kmldpl wrote:

This is really great; thank you so much. I also have thin skin, so expect I'll have the same issues. But waiting is an excellent suggestion.

Thank you so much!

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Mar 6, 2021 03:47PM DiveCat wrote:

Hi JanetM:


My PS does not require compression but said if it was more comfortable for me to go ahead. I definitely found it/find it more comfortable to have some light to moderate compression around my midsection against incision sites and overall as support when moving around. Some PS will require you to wear it so check with your own PS.

I just have some high waisted compression shorts I picked up, like Spanx but a different brand. They come up just under my bust line. Both times I started wearing them about a day after surgery. Last time I wore them around clock (except to shower etc) for about 2 weeks then I switched to just during day when I was more active for another 2-3 weeks.

If you are concerned about mobility after surgery make sure to get ones with snaps or something in the crotch (or modify ones you already have). Will be much easier for bathroom breaks!

My sister for her grafting (thighs at side and back) wore athletic compression tights - again her PS left it to her but she felt it was far more comfortable as it reduced swelling a bit for her.


Hereditary High Risk, Uninformed BRCA Negative Surgery 4/24/2014 Prophylactic mastectomy: Left, Right; Reconstruction (left): Silicone implant; Reconstruction (right): Silicone implant Surgery 3/12/2015 Reconstruction (left): Silicone implant; Reconstruction (right): Silicone implant Surgery 11/14/2019 Reconstruction (left): Silicone implant; Reconstruction (right): Silicone implant Surgery 7/9/2020 Reconstruction (left): Fat grafting; Reconstruction (right): Fat grafting Surgery 12/11/2020 Reconstruction (left): Nipple tattoo; Reconstruction (right): Nipple tattoo Surgery 3/4/2021 Reconstruction (left): Fat grafting; Reconstruction (right): Fat grafting
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Mar 6, 2021 03:53PM DiveCat wrote:

kmdlpl:

No problem. Reconstruction is definitely not a race. Some are lucky to be one and done but there is nothing wrong with taking your time especially if mentally you just aren’t ready for it or “more” procedures. My PS was always very clear I could do the fat grafting “any time” even years later which took the pressure of for me. I really did not want to do fat grafting back in 2014/2015, so didn’t, but felt ready to go ahead a few years later :)

Hereditary High Risk, Uninformed BRCA Negative Surgery 4/24/2014 Prophylactic mastectomy: Left, Right; Reconstruction (left): Silicone implant; Reconstruction (right): Silicone implant Surgery 3/12/2015 Reconstruction (left): Silicone implant; Reconstruction (right): Silicone implant Surgery 11/14/2019 Reconstruction (left): Silicone implant; Reconstruction (right): Silicone implant Surgery 7/9/2020 Reconstruction (left): Fat grafting; Reconstruction (right): Fat grafting Surgery 12/11/2020 Reconstruction (left): Nipple tattoo; Reconstruction (right): Nipple tattoo Surgery 3/4/2021 Reconstruction (left): Fat grafting; Reconstruction (right): Fat grafting
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Mar 6, 2021 05:04PM JanetM wrote:

Thanks so much for the info. My PS has indicated that I will leave surgery in at least an abdominal binder. I think I am mor3 nervous about this than the original BMX and DIEP procedure

DCIS 10/2020 Bilateral Mastectomy Lumpectomy 5/24/11 - LCIS, ALH and ADH and SAH/BSO - 8/10/11 Dx 5/25/2011, LCIS, Left, 0/0 nodes
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Mar 7, 2021 03:18AM Rah2464 wrote:

I didn't do fat grafting for my original direct to implant surgery. I am so glad I waited. The initial surgery is more than enough recovery. When we redid my implants in November, I added in fat grafting. My PS did liposuction on my inner thighs - its somewhat painful and takes a while to resolve. So I think a great idea to do as a second step.

Dx 5/23/2018, IDC, Left, 1cm, Stage IA, Grade 2, 0/4 nodes, ER+/PR+, HER2- (IHC) Surgery 6/27/2018 Mastectomy: Left, Right; Reconstruction (left): Silicone implant; Reconstruction (right): Silicone implant Hormonal Therapy 7/27/2018 Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone)
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Mar 31, 2021 09:02PM JanetM wrote:

Had my fat grafting surgery on 3/26, I am very bruised and sore. Saw my plastic surgeon on 3/30 to take out stitches and everything looks good so far so I was able to finally schedule my 1st fill for 4/27. Can't wait!!!

DCIS 10/2020 Bilateral Mastectomy Lumpectomy 5/24/11 - LCIS, ALH and ADH and SAH/BSO - 8/10/11 Dx 5/25/2011, LCIS, Left, 0/0 nodes
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Apr 1, 2021 07:16AM DiveCat wrote:

Glad to hear it went well JanetM! Where did they take the fat from? Only four days with stitches is nice! I had to keep mine almost two weeks this time. They weren’t bothersome but I did put light gauze on hip incisions to avoid friction from my pants.

My recovery after my first fat grafting surgery felt a lot longer and painful than this last one. I had minimal bruising this time (went yellow/green on tummy almost right away rather than black and blue for weeks!). Don’t even feel like I had surgery a month ago!

I had my follow up with my surgeon a couple weeks ago to remove stitches and check on things. I have been on no restrictions since (were minimal before that though - like don’t go swimming until stitches are out otherwise just don’t do anything that hurts). He mentioned it was a struggle to get fat out this time so I am really hoping this is it - I feel done with all this but I also don’t want to be accessing the thighs. My abdomen is all tapped out it sounds like

Swelling has gone down in breasts so getting a bit better idea of results. I do think so far more fat has stuck at this point than last time so that’s encouraging but I know there is a way to go yet as things smooth out and heal. I don’t expect to have no ripples at all based on my skin and so on but I am definitely hoping that at least results will be reduced rippling. I don’t really want more fat grafting or to go to firmer implants (after having these ones after the 410s I realize how nice for me to have softer ones even with a bit of ripples!). I feel like this is “it”.

I already scheduled my revisit for nipple tattoos in June. I kept my nipples but they lightened even more than they already were after my original surgery and the tatts also help even them out a bit optically. My first round of tattoos faded more than I hoped so going for touch ups.

Hereditary High Risk, Uninformed BRCA Negative Surgery 4/24/2014 Prophylactic mastectomy: Left, Right; Reconstruction (left): Silicone implant; Reconstruction (right): Silicone implant Surgery 3/12/2015 Reconstruction (left): Silicone implant; Reconstruction (right): Silicone implant Surgery 11/14/2019 Reconstruction (left): Silicone implant; Reconstruction (right): Silicone implant Surgery 7/9/2020 Reconstruction (left): Fat grafting; Reconstruction (right): Fat grafting Surgery 12/11/2020 Reconstruction (left): Nipple tattoo; Reconstruction (right): Nipple tattoo Surgery 3/4/2021 Reconstruction (left): Fat grafting; Reconstruction (right): Fat grafting
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Apr 1, 2021 04:33PM JanetM wrote:

He took the fat from my abdomen and sides. I am bruised and swollen all down both sides all the way down my thighs. It hurts to move so I am taking it slow when I get up and down and when I am walking.

I finally feel like I am moving forward with all of this. I am excited to start filling the expanders. It has been very frustrating to not see any progress.

I will likely need another round of fat grafting after the implants are finally in.

Good luck with your nipple tattoo procedure.

DCIS 10/2020 Bilateral Mastectomy Lumpectomy 5/24/11 - LCIS, ALH and ADH and SAH/BSO - 8/10/11 Dx 5/25/2011, LCIS, Left, 0/0 nodes
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Apr 22, 2021 06:16PM JanetM wrote:

Going for first fill of expanders on Tuesday. Hoping for the best even though the right side looks a little weird.

DCIS 10/2020 Bilateral Mastectomy Lumpectomy 5/24/11 - LCIS, ALH and ADH and SAH/BSO - 8/10/11 Dx 5/25/2011, LCIS, Left, 0/0 nodes

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