Monterey Fat Transfer doctors
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Robert M. Lowen, MD
Bay Area Plastic Surgeon
305 South Drive Suite 1, Mountain View |
1 answer | |
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David S. Goldberg, MD
Monterey Plastic Surgeon
24591 Silver Cloud Court Suite 150, Monterey |
Recent Answers
I am 23 and in one week I am having a bilateral prophylactic mastectomy with expanders to implants. I just heard about fat grafting. I am 5' 3", 115lbs and most of my fat are my D size breast. I plan to stay my size or a little smaller when I get implants & know I can't get to that size just by fat grafting. Is it safe if I decide to do a smaller implant then later do fat grafting to help give it a more natural feel? Is there much research about these yet?
Breast reconstruction using fat grafting is a viable and safe alternative to expander-implant or free tissue transfer in the right circumstances.
There has been extensive research and clinical experience in this field. There have been several clinical teaching courses, including the Miami Fat Grafting course directed by Dr. Roger Khouri. See the links below.
You must have sufficient fat, however, to achieve the size you want, and this will be the limiting problem. If you have moderate excess fat, then perhaps a B cup, or about 200 cc per breast may be achievable.
The other issue is that the grafting is done in 2-5 stages and requires the use of an external tissue expander, called the Brava device. This device was first used to try to enhance breasts without implants or fat grafting. It has been found to be an essential and effective adjunct to breast enhancement or reconstruction with fat grafting alone.
It works be applying negative pressure to the breast over a period of weeks. This induces a rich vascular supply to the tissue under the skin. This vascular bed, as it is called, is then receptive to transplantation and permanent survival of your transferred fat.
I have attended this course and believe the results are credible.
If a patient is too thin, however, or wants more than the available fat that can be removed from their body can deliver, then expander-implant reconstruction is an excellent method to achieve a very natural breast reconstruction. In fact, with a nipple sparing prophylactic mastectomy, using an infra-mammary incision, a very natural and soft breast reconstruction with minimal visible scarring can be achieved.