What is Lipofilling and How is It Used for Breast Reconstruction?

Can fat transfer techniques be successfully applied for breast reconstruction? Or are there better methods out there?

Doctor Answers (19)

Fat transfer techniques can aid breast reconstruction

+5

Fat transfer is a useful tool to optimize breast reconstruction outcomes. I recently fat grafted a patient's TRAM flap to improve volume, projection and shaping of the reconstructed breast. Insurance will pay for 'revision of breast reconstruction' and patients benefit from the liposuction required to obtain the fat for grafting. That's a double bonus for the patient !


Seattle Plastic Surgeon
5.0 out of 5 stars 39 reviews

Fat grafting

+4

Fat grafting has been shown to be a reasonable ancillary procedure to "touch-up" monor irregularities with breast reconstruction.

Steven Wallach, MD
Manhattan Plastic Surgeon
4.5 out of 5 stars 18 reviews

Fat grafting in breast reconstruction

+2

One of the newest techniques for breast reconstruction involve utilization of the exciting benefits of fat grafting. Much research has been put forth into plastic surgery for harvesting of fat and its potential as stem cells. Fat grafting and transfer has been utilized both for breast augmentation but also in breast reconstruction for contouring of the breast after implant-based and flap-based reconstruction with excellent results.

After a lumpectomy or mastectomy, an innovative technique which has been implemented is performing this fat grafting and transfer technique to completely reconstruct a breast. This would involve no other scars or incisions, no foreign bodies or implants, and no complex flap procedures. Plus, additional benefits to the breast reconstruction include as close to normal sensation of the breasts along with the benefit of liposuction to harvest the fat from wherever there is spare fat!

Working with your breast surgeon during the oncologic procedure for your breast, some fat is harvested during the same surgery, which in turn is placed back into the breast area. This will give a small breast mound immediately after the procedure. An external expander device is then used for several weeks after the initial procedure while you are sleeping. The expander will have the same befits as the internal tissue expander, owever it is simply worn on the outside as a vest, without having an implanted prosthetic. It has been shown to increase vascualrity, increase blood supply (important for radiated breasts especially), as well as expand the breast framework for which the fat will be placed in the future.

Once adequate expansion has been obtained after several weeks of wearing the external expander vest, a simple outpatient procedure will be performed in which liposuction will be performed from areas where you have excess fat. Instead of wasting this fat, it will be harvested, washed, and then transferred back directly into the breast to give the additional volume to reconstruct the breast. The liposuction may be performed from the abdomen, flanks, hips, thighs, buttocks, etc., until enough fat has been obtained to give adequate volume for your reconstructed breast. Multiple micro-fat grafts will then be placed throughout the expanded breast framework within its well-vascularized bed. Sometimes this will take a few small outpatient procedures, separated by several weeks, to obtain the results. Fat grafting allows precise placement of where the fat should go in order to perfectly contour the breast shape.

The newly-reconstructed breast mound has now been recreated with the use of only your own fat via liposuction with the hopes for a breast mound that looks and feels much like a "normal" breast. The results thus far have been superb and patients have raved about their overall results.  Have a discussion about ALL options available for breast reconstruction with your plastic surgeon, and together, decide which breast reconstruction technique is best for you.

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

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Fat grafting and breast reconstruction

+2

in general, fat grafting (removing fat from one area of the body and injecting into the reconstructed breast) is used to fill-in or refine areas of the reconstructed breast.

Loren Schechter, MD
Chicago Plastic Surgeon
3.0 out of 5 stars 1 review

Fat transfer great for breast reconstruction

+2

Fat transfer can be really useful in breast reconstruction for some patients. Obviously it is not possible to use fat transfer as the only means of reconstruction. Fat transfer is most useful for filling in smaller asymmetries that may still exist following your reconstruction procedures.

Kevin Brenner, MD, FACS
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 15 reviews

Fat transfer or lipofilling and breast reconstruction

+2

Recently advances have been made in techniques to harvest and transfer living fat cells from patients and move them from one part of the body to another. Improving contour issues in breast reconstruction is one situation that fat transfer has an increasingly important role.

Most commonly, fat transfer is used to soften the interface between the edge of the implant and the surrounding tissues. Sometimes, the extent of the mastectomy is beyond where the implant will fill and a sharp stepoff is noted. Fat can be harvested from one part of the body (such as the abdomen, flanks, hips, or thighs) and prepared in such a way as to preserve the most living fat cells. These are then immediately injected into the tissues using special instrumentation that allows the fat to be deposited in small streams to increase the likelihood that the blood supply will grow into the fat tissue.

Sometimes, fat transfer can be used to increase the size of an autologous reconstruction (such as a TRAM flap or DIEP flap), or to correct localized contour deformities.

The use of fat transfer to correct post lumpectomy deformities, to enhance then size of a normal breast without using implants, or to creaste a breast mound without any additional need for tissue transfer or implants are exciting new frontiers that are currently being evaluated.

Stephen U. Harris, MD
Long Island Plastic Surgeon
5.0 out of 5 stars 5 reviews

Fat grafting in breast reconstruction

+2

Fat grafting is often used in breast reconstruction for two main reasons -

  • To correct the "shelf" that occurs between the chest wall and the upper pole of the implant
  • To correct contour irregularities around the implant (palpable ripples, thin areas of skin, etc.)

The fat is removed from another area of your body (abdomen, thighs, hips) and is processed to isolate the fat cells. These fat cells are then injected into the area you wish to fill. Depending on technique, a percentage (the higher the better) of this transplanted fat will "take" or live and thus correct the deformity. Sometimes, more than one surgery is required to correct an area.

Some insurance companies deem this procedure as "investigational" and will not pay for it. It is important to discuss this with your surgeon prior to undergoing fat transfer. Other options include using dermal fat grafts (leaving fat attached to skin and transplanting as a single unit) and dermal matrices such as Alloderm.

David Bogue, MD
Boca Raton Plastic Surgeon
5.0 out of 5 stars 12 reviews

Lipofilling or fat transfer can be very useful in breast reconstruction.

+2

Hi.

Fat transfer is not the primary technique in breast recostruction, but we often use it to add finesse and a more natural look AROUND the main reconstruction.

The main breast reconstruction is done with an implant or a flap. But there can be hollows or defects from the mastectomy around the implant or the flap. This is where filling in with fat injections can turn a good result into a great result.

George J. Beraka, MD (retired)
Manhattan Plastic Surgeon
5.0 out of 5 stars 9 reviews

Fat transfer in breast reconstruction

+1
Fat transfer is a great procedure in breast reconstruction especially in the setting of a lumpectomy defect.  It also works quite nicely to conceal an implant that has little coverage if the mastectomy resulted in thin skin.  It can also be used for reconstructing a breast from "scratch".  This is less typically used as the skin does not easily stretch enough to accommodate this.  Multiple surgeries can be used to slowly increase size.  Some surgeons would suggest the Bravia system to be a solution to that problem.  The long and short of it is that you should speak to a surgeon that offers fat transfer as well as all other forms of reconstruction.  They will best be able to advise you on your options as well as the potential risks with each.

Rodger Shortt, FRCSC
Toronto Plastic Surgeon
5.0 out of 5 stars 15 reviews

Lipofilling or fat grafting can be used for breast reconstruction!

+1
You can do the first session at the time of mastectomy by injecting the pec muscle with fat.  Subsequently you can use the BRAVA to externally expand the tissue and perform fat grafting until the desired result is reached.  Also my colleagues in Europe place and expand and fill it to the desired volume.  Once that has been done then they simply add fat graft  while removing volume until the device can be complete removed.Please find an experienced Board Certified Plastic Surgeon and member of the Aesthetic Society using the Smart Beauty Guide. These Plastic Surgeons can guide you on all aspects of facial surgery, breast augmentation and body procedures including tummy tucks or mommy makeovers! Please read reviews of the surgeons to find the right fit for you!.


Robert Whitfield, MD, FACS
Austin Plastic Surgeon
5.0 out of 5 stars 14 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.