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Topic: Fat Graft Transfer and the Radiated Breast

Forum: Radiation Therapy - Before, During, and After —

What to expect from treatment and ways to cope with side effects.

Posted on: Dec 3, 2009 01:47PM - edited Mar 1, 2014 01:11AM by whippetmom

whippetmom wrote:

I started this thread in 2009, and since that time, further data has been published regarding the efficacy of utilizing stem-cell enriched fat graft transfer in previously irradiated breast tissue. 

Since links are often malfunctioning, I am posting the most recent information, so that you can easily cut and paste and print out to take to your plastic surgeons.

Print out these articles:

http://www.ncbi.nlm.nih.gov/pubmed/21987041

http://www.ncbi.nlm.nih.gov/pubmed/23158103

http://www.plasticsurgery.org/News-and-Resources/Technique-Provides-New-Option-for-Breast-Reconstruction-after-Radiation-Therapy.html

Autologous Fat Grafting in Secondary Breast Reconstruction

Losken, Albert MD; Pinell, Ximena A. MD; Sikoro, Katherine MD; Yezhelyev, Maksym V. MD; Anderson, Erica MD; Carlson, Grant W. MD

Abstract Autologous fat grafting has become a common technique for revisional breast surgery. The purpose of this series is to review our experience with fat grafting for the correction of acquired breast deformities. A retrospective review was performed on 107 patients with a history of breast cancer between 1996 and 2010, who had autologous fat grafting at the time of secondary breast reconstruction. The indications were for improvement in contour, shape, and volume of the breast following transverse rectus abdominis myocutaneous (TRAM) flap reconstruction (n = 55), latissimus dorsi with or without implant (n = 20), implant reconstruction (n = 20), and breast conservation therapy deformity (n = 12). The average volume of injection was 40 mL (range, 5-150 mL), the most common location being upper and medial quadrants. Fat was harvested mainly from the abdomen, thighs, and flanks. Complications occurred in 11% of the patients, and included fat necrosis, erythema, keloid scarring, and pain. Complications were higher when performed with implant reconstructions. Repeat fat injection was performed in 25% (n = 27/107), which increased with the length of follow-up. Patients with a history of radiation therapy had an increased incidence of repeat injections (36% vs. 18%). Patients with >6 months follow-up reported an improvement of about 83%. Autologous fat grafting is a safe and effective tool for secondary breast reconstruction. It is helpful in all types of reconstructions to improve contour, volume, and overall breast shape and symmetry. Repeat injections are often required and this is more common in patients with longer follow-up and in those with a history of radiation therapy. The popularity of this approach in reconstructive breast surgery will likely continue to increase. © 2011 Lippincott Williams & Wilkins, Inc. Fat Grafting and Breast Reconstruction with Implant:  Another Option for the Irradiated Breast Cancer Patients. Salgarello M, Visconti G, Barone-Adesi L. Source Assistant Professor, Department of Plastic and Reconstructive Surgery, Catholic University of "Sacro Cuore" - University Hospital "A. Gemelli" - Largo A. Gemelli 8, 00168 Rome, Italy; Resident in-training, Department of Plastic and Reconstructive Surgery, Catholic University of "Sacro Cuore" - University Hospital "A. Gemelli"- Largo A. Gemelli 8, 00168 Rome, Italy; Consultant Plastic Surgeon - Breast Unit - Catholic University of "Sacro Cuore" - University Hospital "A. Gemelli" - Largo Gemelli 8, 00168 Rome, Italy. Abstract BACKGROUND: In postmastectomy radiated patients, autologous tissue reconstruction is preferred over the implant one, because the latter is associated with a higher rate of postoperative complications. However, autologous tissue reconstruction is not always feasible and is sometimes refused by the patient. A challenge also arises in breast-conserving surgery patients, seeking breast augmentation with implant. In this paper, the authors present a further reconstructive option for irradiated breast cancer patients, consisting of fat grafting followed by implant placement. PATIENTS AND METHODS: The authors retrospectively reviewed sixteen cases of irradiated breasts treated with fat grafting and subsequent alloplastic reconstruction/breast augmentation. The evaluation methods were clinical and photography-based assessments. The BREAST-Q was used to quantify patient satisfaction. RESULTS: Sixteen patients, with a pre-treatment LENT-SOMA score of 1 and 2, underwent two to three fat graftings to achieve a LENT-SOMA score of 0. The placement of the breast implant had been performed in a separate stage at least three months after the last grafting session. The average follow-up was 15 months. The reconstructive outcomes were graded from excellent to good in 93.7 percent of patients. Patient satisfaction was marked high to very high. There were no short-term complications. A Baker grade 1 capsule contracture was found in all patients. CONCLUSION: The authors' experience shows that breast fat grafting followed by implant placement may represent a feasible reconstructive option in high selected patients with irradiated breasts. Fat grafting seems to reduce the radiation-induced complications in implants. Larger studies with a longer follow-up are needed.
PMID:
21987041
[PubMed - as supplied by publisher]

Lauren Greenfield, MD's blog [a California plastic surgeon]

http://www.laurengreenbergmd.com/uncategorized/breast-reconstruction-after-breast-cancer-using-fat-grafts/

As you can see, there are numerous studies which have been performed to substantiate that fat graft transfer [even to a breast where the implant is already in place] can change the integrity of the radiated skin.  It can soften the skin and apparently can also reduce a higher grade capsular contracture which otherwise might require surgical intervention, to a Grade 1 which would require no intervention.  Fat grafting is also a method by which symmetry to the irradiated breast can be made to more closely match the non-irradiated breast.

MASSAGING DURING EXPANSION 

From an interview by D r. Weiss here on bc.org

Maurice Nahabedian Yes. Also, in patients who've had radiation to implants (expanders) I recommend an aggressive massaging protocol to help maintain the soft consistency of the reconstructed breast.
Marisa Weiss, M.D. Can you explain what you mean by this massage protocol?
Maurice Nahabedian I recommend they use some sort of a moisturizing lotion and massage the breast two to three times a day to retain the moisture and also to help control the amount of scar tissue that forms around the implant/expander.
DISCLAIMER! I am not a physician or medical professional. The information provided is my own personal opinion. You must discuss every aspect of your reconstruction with your plastic surgeon. Dx 10/15/2008, IDC, 1cm, Stage IA, Grade 2, 0/1 nodes, ER+/PR+, HER2-
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Posts 151 - 180 (198 total)

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Jan 22, 2016 09:38AM Suz-Q wrote:

Has anyone done fat transfer to lumpectomy site? I just finished radiation and my PS said to wait 6 months before I have a consultation.

56 at diagnosis. Oncotype DX 10 Dx 9/17/2015, DCIS/IDC, Right, <1cm, Stage IA, Grade 2, 0/2 nodes, ER+/PR+, HER2- Surgery 11/3/2015 Lumpectomy: Right; Lymph node removal: Sentinel Radiation Therapy 12/14/2015 Whole-breast: Breast Hormonal Therapy 1/21/2016 Arimidex (anastrozole) Surgery 8/4/2016 Reconstruction (right): Fat grafting Hormonal Therapy 10/7/2017 Aromasin (exemestane)
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Jan 28, 2016 12:51PM whippetmom wrote:

Suz-Q: I have known a few gals who were going to have this done, after lumpectomy. It is a pretty common procedure now...and has a pretty good success rate. You might only need one session or you might need two. If the latter, they are usually done by spacing out at least 4 to 6 months.
DISCLAIMER! I am not a physician or medical professional. The information provided is my own personal opinion. You must discuss every aspect of your reconstruction with your plastic surgeon. Dx 10/15/2008, IDC, 1cm, Stage IA, Grade 2, 0/1 nodes, ER+/PR+, HER2-
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Jan 28, 2016 03:31PM Suz-Q wrote:

Thanks whippetmom. I'm having a hard time finding doctors who do this procedure. I know that there are many well qualified docs doing this, but I'm having a hard time figuring out who they are!

56 at diagnosis. Oncotype DX 10 Dx 9/17/2015, DCIS/IDC, Right, <1cm, Stage IA, Grade 2, 0/2 nodes, ER+/PR+, HER2- Surgery 11/3/2015 Lumpectomy: Right; Lymph node removal: Sentinel Radiation Therapy 12/14/2015 Whole-breast: Breast Hormonal Therapy 1/21/2016 Arimidex (anastrozole) Surgery 8/4/2016 Reconstruction (right): Fat grafting Hormonal Therapy 10/7/2017 Aromasin (exemestane)
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Jan 28, 2016 04:34PM lane4 wrote:

Suz-Q, I had fat grafting after a partial mastectomy and I am very pleased with the results. I waited until a year after I finished radiation to have the procedure done, then I went back for a second round a year later. It is very, very important to find a plastic surgeon who has a lot of experience with fat grafting.

Dx 8/10/2009, DCIS, Right, 1cm, Stage 0, Grade 2, ER+/PR+ Radiation Therapy 10/25/2009 Breast Surgery Lumpectomy: Right; Reconstruction (right): Fat grafting
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Jan 28, 2016 08:11PM dancetrancer wrote:

SuzieQ, there is a member on fatgraftpatients.com who had grafting after lumpectomy and radiation. You may want to read her story - although she waited many years before grafting and had had a lot of shrinkage, so she needed multiple procedures. Search for her thread - GerryMc.

Cold caps work! coldcapphotos.shutterfly.com/p... TCH: 4/10 - 6/13/12; 33 rads; BMX w/fat grafting; DX: 7/29/11 @ age 43: Stage 1A on L (3 mm IDC w/ 6 cm DCIS, Gr 2 ER/PR+, HER2+) 0/3 nodes; Stage 0 on R (2 mm DCIS); see bio.
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Jan 29, 2016 04:09PM Suz-Q wrote:

Thanks lane4 and dancetrancer!

Dancetrancer, I registered on fatgraftpatients.com but can't figure out how it works. I can't seem to see any post or join any discussions. I can log in

56 at diagnosis. Oncotype DX 10 Dx 9/17/2015, DCIS/IDC, Right, <1cm, Stage IA, Grade 2, 0/2 nodes, ER+/PR+, HER2- Surgery 11/3/2015 Lumpectomy: Right; Lymph node removal: Sentinel Radiation Therapy 12/14/2015 Whole-breast: Breast Hormonal Therapy 1/21/2016 Arimidex (anastrozole) Surgery 8/4/2016 Reconstruction (right): Fat grafting Hormonal Therapy 10/7/2017 Aromasin (exemestane)
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Jan 30, 2016 12:29PM dancetrancer wrote:

Suz-Q,

I emailed the administator of the site. She says it can take up to 24 hours for access to be granted after registering. I hope you've been able to get on by now. Lots of good information there.

DT

Cold caps work! coldcapphotos.shutterfly.com/p... TCH: 4/10 - 6/13/12; 33 rads; BMX w/fat grafting; DX: 7/29/11 @ age 43: Stage 1A on L (3 mm IDC w/ 6 cm DCIS, Gr 2 ER/PR+, HER2+) 0/3 nodes; Stage 0 on R (2 mm DCIS); see bio.
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Jan 31, 2016 07:43AM Suz-Q wrote:

thank you dancetrancer! I was able to see everything last night. I guess I'm just avery impatient person!

56 at diagnosis. Oncotype DX 10 Dx 9/17/2015, DCIS/IDC, Right, <1cm, Stage IA, Grade 2, 0/2 nodes, ER+/PR+, HER2- Surgery 11/3/2015 Lumpectomy: Right; Lymph node removal: Sentinel Radiation Therapy 12/14/2015 Whole-breast: Breast Hormonal Therapy 1/21/2016 Arimidex (anastrozole) Surgery 8/4/2016 Reconstruction (right): Fat grafting Hormonal Therapy 10/7/2017 Aromasin (exemestane)
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Jan 31, 2016 07:50AM dancetrancer wrote:

Glad you were able to get in the site! Hope it helps! You aren't impatient, our site just works a little differently than most. I think the reason the admin approves each registrant is that she wants to be careful about trying to make sure spammers don't come on and take over the site.

Cold caps work! coldcapphotos.shutterfly.com/p... TCH: 4/10 - 6/13/12; 33 rads; BMX w/fat grafting; DX: 7/29/11 @ age 43: Stage 1A on L (3 mm IDC w/ 6 cm DCIS, Gr 2 ER/PR+, HER2+) 0/3 nodes; Stage 0 on R (2 mm DCIS); see bio.
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May 17, 2016 05:24PM dianasav8 wrote:

hi there! I am going thru exactly the same thing u are! I was wondering what u ended up doing and if u can share it expirence with me

Dx 9/2015, IDC, Right, 3cm, Stage IB, Grade 1, 1/2 nodes, ER+/PR+, HER2- Chemotherapy 10/8/2015 AC + T (Taxol)
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May 17, 2016 05:28PM dianasav8 wrote:


Madison

hi there! I am going thru exactly the same thing u are! I was wondering what u ended up doing and if u can share it expirence with me! I am having healing issues with my reconstruction and I have to start my radiation. My doctor wants to do fat rafting to the radiated tissue but I'm scared! I have and expander in there and issues with skin being too thin. I had neurotic skin the whole God aweful bag of complications healing u can have on top of radiation

PS He wants to do fat grafting I saw another doctor wants to do latissimus flap anyone please help me. I don't even know what I'm going to do anymore! Radiation is scaring me as much as the stupid chemo and I thoyht that was hard!

Dx 9/2015, IDC, Right, 3cm, Stage IB, Grade 1, 1/2 nodes, ER+/PR+, HER2- Chemotherapy 10/8/2015 AC + T (Taxol)
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May 17, 2016 05:39PM dianasav8 wrote:


Madison

hi there! I am going thru exactly the same thing u are! I was wondering what u ended up doing and if u can share it expirence with me! I am having healing issues with my reconstruction and I have to start my radiation. My doctor wants to do fat rafting to the radiated tissue but I'm scared! I have and expander in there and issues with skin being too thin. I had neurotic skin the whole God aweful bag of complications healing u can have on top of radiation

PS He wants to do fat grafting I saw another doctor wants to do latissimus flap anyone please help me. I don't even know what I'm going to do anymore! Radiation is scaring me as much as the stupid chemo and I thoyht that was hard!

Dx 9/2015, IDC, Right, 3cm, Stage IB, Grade 1, 1/2 nodes, ER+/PR+, HER2- Chemotherapy 10/8/2015 AC + T (Taxol)
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May 17, 2016 05:57PM dancetrancer wrote:

Madison - both fat grafting and lat flap will bring healthy tissue to the area.

Fat grafting alone requires multiple surgeries to help heal the tissue. You need to go to a doc who has lots of experience with it, especially if you have limited fat stores to work from.

A lat flap will likely be one surgery. Maybe two. So, fewer surgeries and done faster with recon. However, it is using a muscle, so there may be complications associated with that. And there is always a chance the flap will fail.

Pro's and cons of each surgery.

Implants often don't do well with radiation, unfortunately. :( Some do ok with them but it is unpredictable.

Cold caps work! coldcapphotos.shutterfly.com/p... TCH: 4/10 - 6/13/12; 33 rads; BMX w/fat grafting; DX: 7/29/11 @ age 43: Stage 1A on L (3 mm IDC w/ 6 cm DCIS, Gr 2 ER/PR+, HER2+) 0/3 nodes; Stage 0 on R (2 mm DCIS); see bio.
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Jun 1, 2016 02:27AM damazon wrote:

just to share my most recent experience and yet I am not unhappy that I did not figure it out earlier. ADM, cadaver tissue, looks like human, eliminates the mastectomy scar(s) and all is completed within 3 months. Very few Surgeons do this and had heard of it but thought it meant simply an interior sling. Could have had the same size or much larger breasts in a much shorter period with a much greater success without likely complications. However I am over 50 so perhaps it is not as meaningful, in terms of cosmetic enhancement.

Dx 3/8/2011, ILC, 6cm+, Stage IIIA, Grade 1, 2/3 nodes, ER+/PR-, HER2-
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Jun 3, 2016 01:53PM ual0307 wrote:

HI damazon

Tell me more about this....what do you mean eliminates the mx scar....are you talking about alloderm?


thanks

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Jun 8, 2016 12:09PM - edited Jun 8, 2016 07:15PM by Tessy

Has any one had an MRI that showed "areas of low concern" after having fat grafting done? I had an MRI on Monday and there were 3 areas of low concern that they think may be from the fat grafting I had done in Oct 2014. That was on the non-mastectomy side. I also had some done on the mastectomy/implant area and developed marble size lumps on the top of the breast area which scared the snot out of me (US showed that it was fat). Now I have to have those areas on the left side biopsied. Another procedure and more stress but I guess its better to find out for sure.

Dx 11/21/2012, ILC, 3cm, Stage IIIC, Grade 2, 11/18 nodes, ER+/PR+, HER2- Surgery 1/7/2013 Lymph node removal: Right, Underarm/Axillary; Mastectomy: Right; Reconstruction (right): Tissue expander placement Chemotherapy 2/4/2013 Adriamycin (doxorubicin), Cytoxan (cyclophosphamide), Taxotere (docetaxel) Radiation Therapy 6/16/2013 Breast, Lymph nodes Hormonal Therapy 9/1/2013 Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone) Surgery 1/8/2014 Reconstruction (left) Surgery 1/8/2014 Reconstruction (right) Hormonal Therapy 8/3/2014 Femara (letrozole)
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Jun 8, 2016 12:28PM ABeautifulSunset wrote:

Tessy, I have internal scarring /inflammation from fat grafting that shows up on scans and they always make note of it. it's a good baseline, in case they see changes later, but not concerning.

Stefajoy

“Sunsets are proof that endings can be beautiful too.” Dx 7/29/2011, Left, Stage IV, metastasized to bone/liver, ER+/PR+, HER2- Targeted Therapy Afinitor (everolimus) Chemotherapy Xeloda (capecitabine) Chemotherapy Xeloda (capecitabine) Chemotherapy TAC Targeted Therapy Ibrance (palbociclib) Surgery Mastectomy; Reconstruction (left): Fat grafting, Silicone implant, Tissue expander placement; Reconstruction (right): Fat grafting, Silicone implant, Tissue expander placement Hormonal Therapy Aromasin (exemestane), Faslodex (fulvestrant), Femara (letrozole)
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Jun 8, 2016 04:55PM dancetrancer wrote:

My MRI's have all been clear. I've had plenty of small lumps develop that needed to be ruled out by ultrasound. All benign fatty necrosis. I've not had to have any biopsied. The radiologist can easily tell it is necrosis via ultrasound. Make sure you are going to a radiologist who is familiar with reading imaging after fat grafting. Seems to me the newer docs are just fine with this, the older docs aren't used to it and get more cautious/scare you unnecessarily. Just my personal experience. YMMV.

Cold caps work! coldcapphotos.shutterfly.com/p... TCH: 4/10 - 6/13/12; 33 rads; BMX w/fat grafting; DX: 7/29/11 @ age 43: Stage 1A on L (3 mm IDC w/ 6 cm DCIS, Gr 2 ER/PR+, HER2+) 0/3 nodes; Stage 0 on R (2 mm DCIS); see bio.
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Jun 12, 2016 12:14PM damazon wrote:

Hi Ual,

Apparently. The woman I spoke with had mx 4.5 yrs ago after large tumour. She had other breast removed in December and full tissue expansion in under 6 weeks for both breasts and fully rebuilt and completion of both breasts (implants)using cadaver skin on original mx side (little useable skin) to bring her to a full volume C size. The whole procedure done in under 3 months. She is currently 53 and a large woman. My sister saw the scar and said it was hardly evident except the skin was of a slightly lighter tone where she was expanded. Interesting?

Dx 3/8/2011, ILC, 6cm+, Stage IIIA, Grade 1, 2/3 nodes, ER+/PR-, HER2-
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Jun 12, 2016 06:19PM littleblueflowers wrote:

Hi ladies, I'm hoping someone has had a similar experience to this: I have a lump exactly where the stitch was which closed my fat grafting wound. I called my BS, but he can't get me in until next Thursday. It is on my radiated side. I'm pretty scared, and of course it's Sunday night. Could it be from the fat grafting? Or cancer returning.....:/

If it stops the nightmares, it probably won't kill me Dx 3/9/2015, IDC, Left, 1cm, Stage IB, Grade 3, 2/16 nodes, ER-/PR-, HER2- Surgery 3/9/2015 Mastectomy: Left, Right Radiation Therapy Lymph nodes Chemotherapy AC + T (Taxol)
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Jun 12, 2016 07:37PM anotherNYCGirl wrote:

My hunch is scar tissue! Try not to panic! Let us know what dr says, - but i bet he says it's nothing!

Dx 1998, DCIS, Stage 0 Surgery 3/18/1998 Lumpectomy: Left Dx 6/2000, ILC, Stage IA, 0/3 nodes, ER+/PR+, HER2- Surgery 7/11/2000 Lumpectomy: Right; Lymph node removal: Right, Sentinel Chemotherapy 8/1/2000 CMF Hormonal Therapy 2/11/2001 Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone) Radiation Therapy 2/12/2001 Breast Hormonal Therapy 2/12/2006 Femara (letrozole) Dx 2/2014, ILC, Grade 3, 0/3 nodes, ER-/PR-, HER2- Surgery 3/25/2014 Lymph node removal: Left, Right; Mastectomy: Left, Right; Reconstruction (left): Tissue expander placement; Reconstruction (right): Tissue expander placement Chemotherapy 5/2/2014 AC + T (Taxol) Surgery 11/20/2014 Reconstruction (left); Reconstruction (right) Surgery 1/14/2015 Reconstruction (right): Tissue expander placement Surgery 5/28/2015 Reconstruction (right): Latissimus dorsi flap, Silicone implant Surgery 2/22/2016 Reconstruction (left): Fat grafting, Nipple reconstruction; Reconstruction (right): Fat grafting, Nipple reconstruction
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Jun 13, 2016 07:10PM littleblueflowers wrote:

Thank you! As we all know, waiting is hell. I'm trying to stay calm...

If it stops the nightmares, it probably won't kill me Dx 3/9/2015, IDC, Left, 1cm, Stage IB, Grade 3, 2/16 nodes, ER-/PR-, HER2- Surgery 3/9/2015 Mastectomy: Left, Right Radiation Therapy Lymph nodes Chemotherapy AC + T (Taxol)
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Jun 20, 2016 05:14PM Tessy wrote:

I had my MRI guided biopsy last Tuesday. It was pure hell. Never again will I go thru that! Thank goodness the biopsy results showed fat necrosis and not cancer.

Dx 11/21/2012, ILC, 3cm, Stage IIIC, Grade 2, 11/18 nodes, ER+/PR+, HER2- Surgery 1/7/2013 Lymph node removal: Right, Underarm/Axillary; Mastectomy: Right; Reconstruction (right): Tissue expander placement Chemotherapy 2/4/2013 Adriamycin (doxorubicin), Cytoxan (cyclophosphamide), Taxotere (docetaxel) Radiation Therapy 6/16/2013 Breast, Lymph nodes Hormonal Therapy 9/1/2013 Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone) Surgery 1/8/2014 Reconstruction (left) Surgery 1/8/2014 Reconstruction (right) Hormonal Therapy 8/3/2014 Femara (letrozole)
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Mar 11, 2017 05:35AM - edited Mar 11, 2017 05:36AM by PeppermintPatti

I appreciate this post. My PS discussed fat grafting with me during my last fill. I'm currently at 400 ccs and he feels he may want to stop here. I had both of my breasts irridated almost 19 years ago left and 10 years ago right respectively. The radiated areas are not expanding like the rest of the breast on both sides. Although he was more concerned about wound healing with me, which is not the case at all. I knew these limits I might face prior to surgery since the PS discussed it with me. I was just feeling a bit discouraged and ended up texting him stating "I hope I'll look ok". He replied "We'll take it one step at a time. Try not to worry". I appreciated his comments and support. I never was "all about my breasts" but after my bilateral mastectomy, all of a sudden my breasts became more important! After going through DCIS surgeries 3x in nearly 19 years, 1/3 of my life, i guess my breasts have always been on my mind! 😄😄

"No matter what's going on, I found, we all still need to buy toilet paper!" Dx 11/1998, DCIS, Left, <1cm, Stage 0, ER-/PR-, HER2- Dx 11/2006, DCIS, Right, <1cm, Stage 0, ER-/PR-, HER2- Dx 11/2016, DCIS, Right, <1cm, Stage 0, ER-/PR-, HER2- Radiation Therapy Whole-breast: Breast Radiation Therapy Whole-breast: Breast Radiation Therapy
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Jan 13, 2018 08:42PM Imkopy2 wrote:

bumping in the hopes it creates some new disc

If it doesn’t challenge you it won’t change you Dx 3/7/2016, DCIS/IDC, Right, 3cm, Stage IIB, Grade 3, 3/8 nodes, ER+/PR-, HER2- Surgery 4/12/2016 Lymph node removal: Sentinel, Underarm/Axillary; Mastectomy: Left, Right; Prophylactic mastectomy: Left; Reconstruction (left): Tissue expander placement; Reconstruction (right): Tissue expander placement Chemotherapy 5/23/2016 AC + T (Taxol) Radiation Therapy 10/23/2016 Whole-breast: Breast, Lymph nodes Hormonal Therapy 1/24/2017 Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone) Surgery 3/7/2017 Reconstruction (left): Fat grafting, Silicone implant; Reconstruction (right): Fat grafting, Silicone implant Surgery 9/26/2017
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Jan 13, 2018 08:45PM Imkopy2 wrote:

Having fat grafting to radiated breast in April in an attempt to soften the skin and muscle. Had my exchange surgery in March looking for any one out there who may have info out there to help. Thanks!

If it doesn’t challenge you it won’t change you Dx 3/7/2016, DCIS/IDC, Right, 3cm, Stage IIB, Grade 3, 3/8 nodes, ER+/PR-, HER2- Surgery 4/12/2016 Lymph node removal: Sentinel, Underarm/Axillary; Mastectomy: Left, Right; Prophylactic mastectomy: Left; Reconstruction (left): Tissue expander placement; Reconstruction (right): Tissue expander placement Chemotherapy 5/23/2016 AC + T (Taxol) Radiation Therapy 10/23/2016 Whole-breast: Breast, Lymph nodes Hormonal Therapy 1/24/2017 Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone) Surgery 3/7/2017 Reconstruction (left): Fat grafting, Silicone implant; Reconstruction (right): Fat grafting, Silicone implant Surgery 9/26/2017
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Jan 14, 2018 04:32PM Imkopy2 wrote:

bumping

If it doesn’t challenge you it won’t change you Dx 3/7/2016, DCIS/IDC, Right, 3cm, Stage IIB, Grade 3, 3/8 nodes, ER+/PR-, HER2- Surgery 4/12/2016 Lymph node removal: Sentinel, Underarm/Axillary; Mastectomy: Left, Right; Prophylactic mastectomy: Left; Reconstruction (left): Tissue expander placement; Reconstruction (right): Tissue expander placement Chemotherapy 5/23/2016 AC + T (Taxol) Radiation Therapy 10/23/2016 Whole-breast: Breast, Lymph nodes Hormonal Therapy 1/24/2017 Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone) Surgery 3/7/2017 Reconstruction (left): Fat grafting, Silicone implant; Reconstruction (right): Fat grafting, Silicone implant Surgery 9/26/2017
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Jan 19, 2018 12:51PM Suz-Q wrote:

I've had FG three times. What kind of information are you looking for?


56 at diagnosis. Oncotype DX 10 Dx 9/17/2015, DCIS/IDC, Right, <1cm, Stage IA, Grade 2, 0/2 nodes, ER+/PR+, HER2- Surgery 11/3/2015 Lumpectomy: Right; Lymph node removal: Sentinel Radiation Therapy 12/14/2015 Whole-breast: Breast Hormonal Therapy 1/21/2016 Arimidex (anastrozole) Surgery 8/4/2016 Reconstruction (right): Fat grafting Hormonal Therapy 10/7/2017 Aromasin (exemestane)
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Jan 20, 2018 04:14PM Imkopy2 wrote:

SuzQ-

Thank you so much for responding. I had my TE removed at FG done for contouring purposes last March. Wasn’t thrilled with my final results and my original PS said they looked fine especially considering I had radiation in my right breast. Overall my skin looks really good, faint discoloration but certainly a bit of a size difference. I asked about FG and he was very dismissive and told me that I shouldn’t believe what the women on this site are saying. I went out to search for a new PS. My new PS has done research and agrees FG helps the integrity of radiated tissue. I am having FG done in April along with nip recon to both breasts. Wondering what my level of expectation should be will it soften the breast? There is a small area where the skin by my masectomy scar is tighter and makes it slightly lower than the tissue on the side, wondering if FG will/ can plump this area a bit. Also, if I should wait for nip recon until after the FG heals, not sure how much (if any) the radiated tissue will change. Of course these are questions I will ask my surgeon but I’m looking for advice from someone who has been there. Thanks so much for any guidance you can give me.

Hugs Michelle

Also, did you have nip recon, I know there are mixed emotions for women who have had rads... thanks again, hope you are well.

If it doesn’t challenge you it won’t change you Dx 3/7/2016, DCIS/IDC, Right, 3cm, Stage IIB, Grade 3, 3/8 nodes, ER+/PR-, HER2- Surgery 4/12/2016 Lymph node removal: Sentinel, Underarm/Axillary; Mastectomy: Left, Right; Prophylactic mastectomy: Left; Reconstruction (left): Tissue expander placement; Reconstruction (right): Tissue expander placement Chemotherapy 5/23/2016 AC + T (Taxol) Radiation Therapy 10/23/2016 Whole-breast: Breast, Lymph nodes Hormonal Therapy 1/24/2017 Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone) Surgery 3/7/2017 Reconstruction (left): Fat grafting, Silicone implant; Reconstruction (right): Fat grafting, Silicone implant Surgery 9/26/2017
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Jan 20, 2018 05:42PM dancetrancer wrote:

FG definitely helped my radiated tissue. It became MUCH softer (it was like a rock, almost) and my shoulder range of motion also returned to nearly normal. The radiated tissue still of course isn't 100% normal, but it is significantly better. I had severe radiation fibrosis and even had to take pentoxifyillen for over 1.5 years to try to bring more blood flow to the area.

I had 4 fat grafts post radiation. Don't expect a huge difference in volume with each graft. It takes multiple surgeries, IMO - but I guess that depends on what your goal is.

I also used Brava domes to enhance circulation...not fun...and not for everyone. Note - I do not have implants.

Definitely do NOT do nipple recon unless you have had multiple fat grafts first. The tissue does not heal the same. Even after 4 fat grafts after radiation, my nipple recon took months to heal, and that was with careful DAILY dressing changes. It did turn out quite successful, but I had a very skilled surgeon and I also was very dedicated to careful daily wound care for a few months.

Cold caps work! coldcapphotos.shutterfly.com/p... TCH: 4/10 - 6/13/12; 33 rads; BMX w/fat grafting; DX: 7/29/11 @ age 43: Stage 1A on L (3 mm IDC w/ 6 cm DCIS, Gr 2 ER/PR+, HER2+) 0/3 nodes; Stage 0 on R (2 mm DCIS); see bio.

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