Ancillary procedures after reconstruction
Fat grafting is beneficial to help improve contours and fill in deficiencies. If insurance is covering this, I prefer to do this in the OR with anesthesia. As for nipple reconstruction, I have a very poor opinion of their successes and some surgeons are much better than others at creating a nipple that actually lasts longer than a year. I suggest to my patients to consider 3D tattooing and use of prosthetics you can get from amoena.com. I personally have not seen a nice reconstructed nipple hold its size and projection beyond a year.
Nipple reconstructing and fat grafting
In general, nipple reconstruction is a very straight forward small procedure and usually not too uncomfortable. Fat grafting should not be too bad either. The donor sites may be a bit sore, and the chest area may be a bit sore as well.
Nipple reconstruction/fat grafting after double mastectomy, and implant reconstruction. Is it painful?
Hello! Thank you for your question! Congratulations on, what appears to be, approaching your final stages of your breast reconstruction! These two procedures are very well tolerated and can be safely and effectively performed at the same time. Depending on how much fat grafting is needed will also impact the time and pain factors. Typically nipple reconstruction takes about 30' and can be done under even local anesthesia in the office with minimal, if any discomfort. Fat grafting, in small amounts, can also be harvested and placed under local anesthesia. However, the more harvesting and fat grafting needed, the more likelihood that you may require some sedation or general anesthesia, due to the harvesting sites. The longest and most uncomfortable portion is the actual site for the fat harvesting, as it is done via liposuction. Regardless, I estimate 1-2 hrs for the fat grafting portion if an average to large amount is required. You will likely have some bruising/swelling, and mild pain at the donor site of the fat harvesting sites, for which a compression garment or binder is usually recommended. In terms of recovery, you should follow your surgeon's instructions, but would expect you back to routine activities after a week or so, if both done at the same time. Best wishes for a wonderful result!
The hard part is over if you have already had the implants inserted. I think you will think its minor compared to what you have already had done.