Pocket is Stretched to 450cc Nipple and Skin Sparing Mastectomy is D Cup Possibly Fat Grafting Only?

35, due to family history and gene I underwent a n& s sparing mastectomy. I have 450CC implant: D cup. I prefer natural tissue: I will undergo fat stem cell transfer in 6 months time. 1. Is it possible (without an additional implant) to fill my created/strecthed D cup pockets in two or three sessions (over time to collect fat in between)? 2. Or is a C- cup always the maximum cup with fat transfer after a mastectomy? 3. What will my breast look like D cup filled with C volume? Thanks! Audrey.

Doctor Answers 2

Breast reconstruction with your own tissue

If you prefer autologous (own tissue) reconstruction, fat grafting isn't your only option.  As previously mentioned, DIEP (lower abdomen) or TUG (thighs) or PAP (profunda artery perforator flaps from the upper inner thighs) flaps are certainly viable options.  Our practice' breast reconstruction specialist also performs stacked free flap reconstruction, where these flaps are combined to increase the amount to tissue transfered to achieve a larger size.  Or one of these flaps can be used to transfer the majority of the needed amount of tissue, then followed by fat grafting to make up the remainder of the desired size.  In general, using a flap to transfer the majority of the needed volume of tissue would acchieve the desired breast size in fewer operations and decrease the volume loss due to fat necrosis. 

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Yes a D Cup possible with fat grafting alone?

First of all I would have recommended using your own tissue in the beginning so that it would not be such a process for you now.  If you were told you were to thin for DIEP flaps then most likely TUG flaps would have been appropriate.  In any event if you have an expander then the expanders can be deflated and fat grafted added.  The number of sessions varies.  I don't know what devices you have in place at this point but breast reconstruction is a marathon sometimes and not a sprint.

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