Fat Injections After Breast Reconstruction with Implant on Radiated Breast

I had laptoctomy, radiation. 2 years laler - mastactamy and breast reconstruction with expander.After surgery had infection, it was gone after treatment with antibiotics, expander was not removed, but breast shrunk. Quastion - how big risk is to have fat injections when I get permanent implant ?

Doctor Answers (5)

Risk of fat injection on irradiated breast

+2

There are two concerns with your situation. One is blood flow compromise because of radiation, and as fat injections are done, there might be further interference of blood flow. This can cause a complication.  Secondly, there may be an increased risk of infection because of your history, and if the fat injections compromise the sterility of the new implant, it may need to be removed. Speak to your surgeon about these good questions.


Manhattan Dermatologist
5.0 out of 5 stars 31 reviews

Reconstruction of breast

+2

I think you should finish your reconstruction. If you have enough skin, you could have an exchange for a permanent gel implant and a capsule release to allow for a more natural look. If you have any depressions after that, then a revision with fat injections would work well. During the exchange, you will probably need a collagen graft around the implant like Surgimend to decrease the complications that can arrise from the radiation you had.

Luis A. Vinas, MD
West Palm Beach Plastic Surgeon
5.0 out of 5 stars 3 reviews

Fat injections after breast reconstruction with implant on radiated breast.

+1
Thank you for your question!  Fat grafting has become a popular procedure to improve aesthetic outcome following breast reconstruction or for improvement of contour after lumpectomy. Much of the newest research has investigated the properties of fat, in terms of its stem cell properties and associated advantages. It has significantly ameliorated radiation damage by increasing vascularity. Also, it adds additional "fatty tissue" atop the reconstructed breast mound to further contour any concavities or deformities, while also masking implant visibility with rippling and such.  It has been shown to be oncologicaly-safe in several studies

At our Breast Reconstruction Center, we have utilizing this technique almost routinely to maximize the aesthetic outcomes after lumpectomy or mastectomy. We have utilized the micro-fat grafting technique, and have been obtaining maximal fat graft survival into the breast. After harvesting of the fat from areas with excess fat, usually the belly, hips, or thighs, the fat is processed and injected back into the breast using the aforementioned techniques. Our patients have been very happy with the results as well as the areas where the liposuction was performed. Contour has been much improved using the micro-fat grafting technique, and the downtime is minimal.  Fat grafting has become a mainstay in breast reconstruction and has added another edge to breast reconstruction for aesthetics with minimal morbidity and complications.

Best wishes for a wonderful result!

Lewis Albert Andres, MD
Scottsdale Plastic Surgeon
5.0 out of 5 stars 12 reviews

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Fat injection after breast reconstruction

+1

I think that fat transfers may well help in your situation.  It is a useful technique to augment the coverage over implants and can be used in the irradiated breast.

I always worry about leaving an implant in when there has been infection though.  I really do hope that it has all cleared up with the antibiotics, but I find that when you think that you have salvaged the implant, it can flare up again and need to be removed later. 
 

I wish you all the best with your reconstruction.

Jonathan J. Staiano, FRCS (Plast)
Birmingham Plastic Surgeon
5.0 out of 5 stars 9 reviews

Fat injection for Irradiated breasts

+1

The interesting thing is that fat injection seems to reverse some of the effects of radiation. There are reports of fat injection helping to heal radiation related wounds, and I have seen this in practice in my own patients.

Fat also seems to improve breast capsules in several cases that I have used it. I don't think that we fully appreciate the benefits of fat grafting yet.

The thinking that is currently going around is that fat contains stem cells that may account for these effects.

I would not hesitate to use fat injection for irradiated breasts.

However, I still think that autogenous tissue reconstruction is your best bet. Either a pedicled or free flap TRAM flap would be my first choice.

Good Luck

Rodney A. Green, MD
Cleveland Plastic Surgeon
5.0 out of 5 stars 14 reviews

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