Breast fat transfer tips

Question

After multiple complications after two sets of breast implants in 8 years, I’ve had an explant with fat graft of 200 cc per breast during explant, while my tissues were still stretched(implants were 300 low profile). Any tips or advice on how to have the best retention possible? I was an A/small B pre implant with a slightly tuberous breast. Luckily my bases stretched with the implants so my breast shape is better.

Ryan Endress, MD · Answer

Fantastic question! Most of the viability of the fat cells is determined by your surgeon (technique of harvest, filtering, concentrating, injection technique and volume, etc). 200ml is about the max that can be expected to graft without significant fat necrosis, and multiple rounds of grafting is often necessary to achieve desired results. On your end, limiting anything that will constrict blood flow to tissues, such as nicotine products, are to be avoided for at least 4 weeks after surgery. Some providers advocate to avoid significant exercise for a few weeks postop to avoid “burning the fat” that was just grafted, but that is theoretical and has no real literature to support. Maintaining a healthy diet is optimal. Hope this helps!

Nicholas Wingate, MD · Answer

Fat transfer to the breast is an excellent option after breast implant explants. How much can be transferred often depends on the amount of fat that you have available for transfer and the anatomy of your breast after explant.
How well the fat is retained or survives after transfer is mostly dependent on surgical technique Or how the fat is processed between harvest and reinjection. The most important thing that you as the patient can do is avoid any significant pressure to the areas where the fat was transferred for a few weeks after surgery. Any form of nicotine can also hurt the healing process and should absolutely be avoided. There is no clear evidence of any single or combination of supplements or vitamins that will increase fat survival. But generally as you are healing from surgery is a good idea to have a well-balanced diet and stay well-hydrated.

Elizabeth Kiwanuka, MD, PhD · Answer

Congratulations on taking the step to explant and undergo fat grafting! Here are some tips to help ensure the best retention possible for your fat grafts:
1. Follow post-operative care instructions: Adhering to your surgeon's post-operative care instructions is crucial for optimal healing and fat graft retention. This may include wearing compression garments, avoiding strenuous activities, and attending follow-up appointments.
2. Maintain a stable weight: Fluctuations in weight can impact the results of fat grafting. Try to maintain a stable weight to help ensure that the transferred fat cells remain in place and integrate successfully into the surrounding tissues.
3. Avoid smoking and nicotine products: Smoking and nicotine can impair blood flow and compromise the viability of fat grafts. If you smoke, consider quitting or at least abstaining during the recovery period to support the success of your fat grafting procedure.
4. Stay hydrated and eat a healthy diet: Proper hydration and nutrition are essential for tissue healing and cell survival. Stay hydrated and consume a balanced diet rich in vitamins, minerals, and antioxidants to promote optimal healing and fat graft retention.
5. Protect the treated areas: Avoid placing undue pressure or trauma on the treated areas to prevent displacement or damage to the fat grafts. Be mindful of your movements and avoid activities that may strain the chest area during the initial stages of recovery.
6. Be patient and realistic: It's important to understand that fat grafting results may evolve over time as the transferred fat cells settle and integrate into the surrounding tissues. Be patient with the healing process and keep realistic expectations about the final outcome.
7. Communicate with your surgeon: If you have any concerns or questions during the recovery process, don't hesitate to reach out to your surgeon for guidance and support. Your surgeon can provide personalized advice and recommendations based on your individual circumstances.
By following these tips and staying diligent with your post-operative care, you can help optimize the retention of your fat grafts and achieve the best possible outcome from your explant procedure. Best of luck on your journey to recovery and renewed confidence!

Daniel Barrett, MD · Answer

Dear Lexrae,
fat viability depends a lot of surgeon technique. The fat has to be placed back into the buttocks as soon as possible so that it has a greater chance of survival. It has to be placed carefully so that not too much fat is placed in only one area. If you are considering surgery, I would suggest you consult a board-certified plastic surgeon. Only after a thorough examination, you will get more information and recommendations.
Daniel Barrett, MDCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery

Gerald Minniti, MD, FACS · Answer

One round of fat grafting really just sets the stage for another round. Prior to another round, make sure your surgeon uses high resolution ultrasound to ensure that the previous implant pocket has fully resorbed. If it hasn't, there can be small fluid collections where the pockets were; this isn't dangerous, but it would not be desirable to have fat placed inside where it would not take. The volume of your current tissue governs how much fat can be grafted. This is why some people need a third round. This is the unfortunate reality of fat grafting the breasts.

Connie Hiers, MD, FACS · Answer

Do not try to lose weight so that your fat grafts will not shrink. Expanding your breast tissue with implants is usually not helpful for fat grafting since now your actual tissue is thinned and will not support much fat. The fat is not placed in the space of the implant, but in actual breast tissue.

Nhan Ho, MD - Account Suspended · Answer

Dear Lexrae, 
Thanks for your question. To maximize fat retention after a breast fat transfer, follow these tips:- Choose an Experienced Surgeon: Select a board-certified plastic surgeon with expertise in fat transfer.- Maintain Stable Weight: Avoid significant weight changes before and after the procedure.- Avoid Smoking: Quit smoking well before and after surgery to ensure good blood flow and healing.- Post-Operative Care:Wear recommended compression garments.Avoid pressure on the breasts; don't sleep on your stomach.Gradually resume normal activities; avoid strenuous exercise initially.Healthy Diet: Eat a balanced diet rich in nutrients and stay hydrated.Monitor for Complications: Watch for signs of infection and report them to your surgeon immediately.Follow-Up: Attend all follow-up appointments to monitor progress and address any issues.Following these guidelines will help improve the chances of successful fat retention.
Regards,Dr Nhan Ho

Breast fat transfer tips

Answers (7)

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