I had a fat transfer on April 19th for breast reconstruction. I look worse than before. Is this normal after 4 months? (Photo)

I am a 54-year-old personal trainer who had a smooth belly before having liposuction done in the area. I was asked to gain 3-10 pounds to have enough fat for the transfer, and managed to gain 3. I've been massaging the area as instructed, but I look fatter than before, and my stomach has wrinkles and pits and dark splotches now, as well as a dime sized purple scar where the surgical dressing pulled off some skin when the nurse removed it the day after surgery. Will the appearance improve?

Doctor Answers 7

Fat transfer is not a common or reliable method of reconstructing a breast.

Your photos are within the normal range 4 months after your liposuction and fat transfer surgery.  The "wrinkles and pits and dark splotches" are not uncommon.  The dark splotches (hyperpigmentation) will improve with time.  Fat transfer for breast reconstruction is promoted by only a small number of plastic surgeons in the United States, and the results they claim are not able to be duplicated by the vast majority of plastic surgeons, which casts doubt on the reliability of this method.  The vast vast majority of breast reconstructions are done with breast implants, or a patients own tissue in the form of a flap of tissue, not liposuctioned fat.

Houston Plastic Surgeon
5.0 out of 5 stars 2 reviews

Breast Recon

You do not have enough fat for sole fat transfer breast reconstruction.  Is there a plan to do implant or flap reconstruction? Please see a plastic surgeon who performs many breast reconstructions both implants and flaps.  Best wishes.

Jules Walters, MD
New Orleans Plastic Surgeon
5.0 out of 5 stars 50 reviews

I had a fat transfer on April 19th for breast reconstruction. I look worse than before. Is this normal after 4 months?

I am curious what the ultimate plan is for you as far as breast reconstruction. Fat transfer is not a good method for primary reconstruction as the amount of fat that survives is not enough without some breast tissue present or an implant in your case since you have had mastectomies. By liposuctioning your abdomen, it takes away the excess fat that could have been used for a DIEP free flap. I do a lot of breast reconstruction in my practice. Please feel free to email me if you have any questions. 

Erika Sato, MD, FACS
Houston Plastic Surgeon
5.0 out of 5 stars 90 reviews

Breast reconstruction

Fat graft in my hands is effective if you are treat contours or have had a device in place and are grafting after reveal or as a planned removal after combined tissue expansion and fat grafting.  You started with a low body mass index so that is going to be difficult.  It maybe of use to get someone to review your information and perform a physical exam to give you a different perspective on what can be accomplished.

Breast reconstruction

How much fat was transferred. At four months, i don't see much fat around the mounds. i assume you were not radiated after your mastectomy.The abdominal contour is a result of the fat harvest and will get somewhat better. It might be a good idea to think about other options for Breast reconstruction using implants or flaps.

Bijoy Methil, MCh, MS, DNB
India Plastic Surgeon
4.8 out of 5 stars 5 reviews

Breast reconstruction

I don't really see any fat in the place of the breasts.  In order to do  a successful breast reconstruction I usually perform  an implant reconstruction or the use of a flap (muscle from your back or the tummy).  These are big surgeries but are necessary to reconstruct your breasts.   The tummy can have rippling from the liposuction.  Can take several months to improve.  I would seek a consultation with a board certified plastic surgeon that does a lot of reconstruction.

Andrew T. Cohen, MD
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 42 reviews

Breast Reconstruction

You do not seem to have much fat for fat transfer to the breast for a breast reconstruction. The appearance of the abdomen after liposuction is due to overzealous excessive liposuction.You may want to consider another methods of breast reconstruction. As for the abdomen only time will tell how it will look.Do not recommend gaining weight.In person consultation is needed to give you all the options available to you for breast reconstruction. The simplest would be tissue expanders then breast reconstruction with implants. Flaps may be available to you.

Samir Shureih, MD
Baltimore Plastic Surgeon
4.2 out of 5 stars 7 reviews

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