Fat Transfer to Breast and Immunosupressed. Am I a Candidate?

I had breast cancer about 1 1/2 years ago. Had a lumpectomy and radiation. I am considering fat transfer breast surgery to correct asymmetry caused by the lumpectomy. I am also immunosuppressed from kidney and pancreas transplant about 14 years ago. Is the fat transfer surgery even an option for me or too risky?

Doctor Answers 2

Fat transfer to breast in the immunosuppressed patient - am I a candidate?

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Hello! 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.

The decision to have the procedure performed once again will be on you - if you are happy with the results thus far. It is true that some of the fat does resorb (survival rate of fat grafting is 50-80%). 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. It typically takes up to a year to see vascularization of the area, which will ameliorate some of the radiation damage present. Discussion and consultation to examine and determine if it would be safe for you to proceed is warranted.  Hope that this helps! Best wishes!

Scottsdale Plastic Surgeon
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Fat Grafting as an Option

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Thank you for the thoughtful question.  It does sound like fat grafting could play a role in helping reduce asymmetry after your breast cancer treatment.  The surgical plan may change depending on your exam and type of asymmetry.  Fortunately, fat grafting is a low risk surgery although there is always potential for infection and other complication.  Also, if you are taking steroids, there may be reason to believe that the fat may not survive as well as in someone who does not have that issue and reason to have diminished healing ability.  But, I think this certainly merits a consult.  And, it may be best to also get a blessing from the doc who manages your transplant immunosuppression before going forward. 

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