Implant removal with fat transfer 1 year post op. Is fibrous fat common and are there methods around this?

Question

Hey! I had implant removal and fat transfer a year ago. Apparently my fat is fibrous and was very difficult to remove. Is this common? Is there a way around this?

Martin Jugenburg, MD · Answer

Hello, thank you for your question. Typically fat can be fibrous genetically or from previous scarring. You can still harvest fat to use for a fat transfer to breasts. Fat transfers to breast only give you an small increase approx 1/2 a cup size.

Daniel Barrett, MD · Answer

Dear Good426378,
fat transfer breast augmentation is a viable alternative for women who desire larger breasts without the use of implants. Fat transfer is also widely used in reconstruction of the breast after a mastectomy or lumpectomy. It can also be very effective in correcting the size and shape of the breasts due to genetic problems such as tuberous breast or Poland Syndrome, two conditions that look like misshapen or underdeveloped breasts.In addition, the following scenarios are also reason to consider breast fat grafting:• If you have chest areas that appear creased and sunken• If you desire more permanent correction than is provided by temporary fillers• If you wish to improve your body contour, revise scars, fill bodily depressions and rejuvenate the natural curve of your breasts• To fill in contour irregularities or hide obvious signs of breast implantsYou should discuss your concerns with a board certified plastic surgeon and make sure your surgeon understands your concerns and your breast augmentation goals. Only after a thorough examination you will get more information and recommendations.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Ronald J. Edelson, MD · Answer

You don’t say if the photo  is before or after the fat transfer. You don’t have a lot of fat stores available for transfer so it’s going to be hard to find enough fat for a second fat transfer and even more difficult to get it to take.,

Jon S. Wilensky, MD · Answer

Fibrous fat can sometimes develop around implants after a fat transfer procedure. This can be due to the body’s natural response to foreign objects or the healing process. To address this issue, you should consult with a board-certified plastic surgeon who can assess your specific situation.Methods to address fibrous fat may include:1. Massage and manual manipulation: Sometimes, gentle massaging of the affected area can help break down fibrous tissue.2. Liposuction: A surgeon may perform liposuction to remove excess fibrous fat and improve the appearance.3. Revision surgery: In some cases, a revision surgery may be necessary to address the fibrous tissue and reshape the area.It’s crucial to have a thorough consultation with an experienced surgeon who can provide recommendations based on your unique circumstances and goals. Always follow their advice and recommendations for the best possible outcome.

Hilton Becker, MD · Answer

You do not require very much fat to your left breast.
I have developed what is known as a cutting cannula  which is very effective in fat harvesting.
I also combine the fat with PRF obtained from the patients own blood which also adds volume

Connie Hiers, MD, FACS · Answer

Fat itself is not fibrous, but you probably had scar tissue and perhaps fibrous breast tissue which contains little fat.  If you gain weight or go through menopause, the breasts usually become less fibrous and contain more fat.

Mark Hanikeri, MBBS, FRACS · Answer

Hi there

From your photo you have a very low BMI. As we get thinner the proportion of fat, relative to the fibrous network holding the fat together goes down.  This means there is less fat available to harvest.  Only higher BMI patients (BMI over 25) have more easily harvestable fat.  Of course you are better off to have a healthy BMI than to gain weight just for fat harvest.  If you lose weight after fat grafting then the grafted fat will also shrink.  I hope  that helps.

Kind regards

Mark Hanikeri MBBS, FRACS
SPECIALIST PLASTIC SURGEON

Mats Hagstrom, MD (license on probation) · Answer

It is true that different people have different amounts of connective tissue in their fat.
In the end this really should not prevent anyone from being able to harvest sufficient amounts of fat for a proper quality fat transfer procedure.
Based on your picture it should not be all that hard to get sufficient fat for a quality procedure.
Delivering consistent quality liposuction and fat transfer results is more difficult than most people believe and this includes plastic surgeons. The number of plastic surgeons who have truly mastered both Liposuction and fat transfer is relatively small.
With sufficient experience those who are talented at the procedure will eventually get highly consistent and predictable results very consistent with before and after pictures of other patients with similar body characteristics.
The two greatest variables for results for fat transfer is first the amount of tissue someone has to graft into referred to as host tissue. The second variable is the technique and amount of fat grafting.
A successful procedure should double the volume of the breast giving approximately 1/2 and occasionally up to 1 cup breast volume increase.Fat transfer does not change the shape of the breast very much it on the increases its overall size with the shape remaining more or less the same.
Without showing before and after pictures we can’t make an assessment.
One of the disadvantages of having explantation done at the same time as fat transfer is it the patient will not have a reference before picture to know if the Fat transfer was successful or not.
For those seeking liposuction and or fat transfer I recommend being highly selective and properly vetting providers before committing to having surgery.
Do this by having multiple in person consultations at which time you should ask each provider to open their entire portfolio and show you enough before and after pictures to get a clear understanding of what average results will look like.
Being shown a handful of sample pictures is insufficient to get a clear understanding of what the average results look like.
For a fat transfer it is also imperative to have a clear understanding of when after pictures were taken.
Early results can look very impressive but are not at all representative of final results.
An experience provider should be able to cement and no accurately what kind of results each patients will achieve based on experience. They should be able to pull from their collection before and after pictures and point out similar previous cases with patients who had similar body characteristics and be able to replicate accurately.
Getting to the point in one’s career where this is routine and predictable is something many providers never get to.
Blaming your results on having fever and is fat I think it’s just making excuses.
It’s a way for your doctor to avoid taking ownership of that were less than what was predicted.
With enough skill and experience these procedures become very consistent and highly predictable.
They should be very little guessing game involved.
Comes from skill, experience and commitment to mastering the procedure.
You may have to do some searching to find someone who has what it takes to deliver consistent Liposuction and fat transfer results.
Just patients rely on in person consultations and ask providers to open up their entire portfolio. An experience provider should have no difficulty showing you at least 50 sets of before and after pictures of commonly Performed procedures.
I also recommend you ask the provider to show you examples of excellent outcomes, average outcomes and less than outcomes including patients who needed revisions or second rounds a fat transfer.
We all have a variety of outcomes and it’s fair game for patients to ask to see a variety of pictures.
Always confirm the timeframe of when pictures were taken.
It takes a minimum of 3 to 6 months before fat transfer results become final.
Find the right provider and everything falls into place.
Even in the hands of the most talented providers breast fed transfer is a subtle procedure that can never deliver the type of results that implants can.
Who won substantial augmentation are better served staying with breast implants.
Mats Hagstrom MD

Implant removal with fat transfer 1 year post op. Is fibrous fat common and are there methods around this?

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