Use Fat to Improve Flexure Deformity in Implant Reconstruction?
Doctor Answers 6
Fat grafts to improve breast implant reconstruction
When the breast tissue and fat under the skin flap is removed to treat breast cancer or an at risk breast, the implant is now closer to the skin surface and ripples and flexion deformities are more easily seen as the implant shows through. Fat grafts are very helpful in filling the upper portion of the breast, and improving the cover over the implant. In order to properly fill and disperse the grafts it may take more than one session but the results can be rewarding.
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Fat injections not first choice for muscle flexion deformity with implant
The problem you are describing has a specific cause, which is the muscle pulling on the scar capsule around the implants. If it was purely a shape or contour problem without any distortion from flexing the muscle, fat grafts might be a very good choice. When there is a muscle flexion distortion the most effective technique for reconstruction patients is the use of an acellular dermal matrix such as Alloderm. This would also provide better coverage and support so there should be less rippling when you lean forward.
Fat injections for contour irregularity after breast reconstruction
You may get a good cosmetic improvement from fat injections to improve a depression. See a board-certified plastic surgeon whose specialty is breast reconstruction, in consultation, to determine if this is safe for you and what the risks are in terms of ongoing ability to follow you for oncologic reasons.
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Fat grafting and breast reconstruction
Fat grafting is quickly becoming a go to procedure to be able to improve the cosmesis of reconstructive operations. The upper pole (upper breast) is often deficient after most breast reconstructions and fat grafting is an excellent method to improve this issue.
The use of fat fraft in correcting minor and major deformities of the breast after breast reconstruction is very commonly used and is an effective method to fill the upper pole of the reconstructed breast.
Ugly rippling of Breast Reconstruction after mastectomy
Regarding: "Use Fat to Improve Flexure Deformity in Implant Reconstruction?
I had a skin and nipple-sparing mastectomy with silicone implant reconstruction. My result is generally beautiful--except when I flex my chest muscles or bend over. Then, there is lack of fullness in the "upper pole" and ugly rippling. I'm 58, my breasts were reduced from DD to medium C during the procedure, and my implants are moderate profile, just under 300 cc. Do you think fat could improve my result? Thanks for your replies."
Without an examination much less a photograph it is hard to advise you what to do except in generalities. The mastectomy removed all breast tissue leaving the breast implant close to the skin surface. The more soft tissue that can be introduced between the skin and the implant (and its ripples) the less obvious these ripples will be. The use of several sheets of Alloderm of several sessions of fat grafting could well reduce the visibility of the implant rippling you are currently witnessing.
Dr. Peter Aldea
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