Lipofilling Concerns in Breast Reconstruction?

It has been recommended that I have my reconstruction (both sides) using latissimus dorsi followed by Lipofilling as I do not have enough tummy fat for other methods and do not want implants. What are the concerns regarding lipofilling? Do they relate to a possible recurrence of the cancer or are they cosmetic? I am aware that Lipofilling is a relatively new procedure in Breast reconstruction, but there seems to be little information in the public domain about what the concerns may be.

Doctor Answers 4

Lipofilling concerns in breast reconstruction?

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 oncologically-safe in several studies without any increased rate of recurrence. 

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.

Scottsdale Plastic Surgeon
5.0 out of 5 stars 26 reviews

Fat injections

Many plastic surgeons will use fat injections to fill in small areas of tissue deficit or depression after reconstruction, but most are not performing large quantity fat injections for augmentation or overall breast enlargement (even after reconstruction). Injected fat can reaborb, become necrotic, and calcify. Small areas can be monitored easily, but until we know more about how injected fat behaves with time in the breast, large volume fat injections are not recommended outside of a monitored study. You should know, though, that so far fat injections have not been found to be unsafe, including that there is no evidence that they are associated with a higher risk of cancer.

M. Susann Bedford, MD
Atlanta Plastic Surgeon
4.3 out of 5 stars 5 reviews

Fat injection for breast reconstruction

Fat injection into the breast is still a bit controversial. You may want to look into other options like perforator flaps from your buttock region This can be harvested at the top of the buttock a superior gluteal artery perforator flap(SGAP) or from the buttock crease or an inferior gluteal artery perforator flap (IGAP).

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 29 reviews

"Lipofilling" is new and controversial


Placing fat removed by liposuction into a breast, especially one just treated for cancer, is controversial. Ten years ago, it would have been considered malpractice by many plastic surgeons. The concerns were that the fat may degenerate and the products of that degeneration may make surveillance on the reconstructed breast difficult. As it is so new, I consider patients who have it as "test cases" of sorts. I do not do it and await good studies of those who do to determine whether I ever will or not.

Be careful.

John P. Di Saia, MD
Orange Plastic Surgeon
5.0 out of 5 stars 27 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.