One PS brought up a point that implant removal without addressing subsequent cavity can result in scar tissue formation, which can cause contraction that may pull the nipples/areola in unpredictable directions and cause other deformities that will be difficult to correct later, and so recommended that explant/graft be done together. Assuming I have enough fat to harvest, what is the best sequence to replace 300cc IMP with fat? PreIMP A/AA, PostIMP B/small B, Post-Fat ideal B/B over 1-2 tx.
July 12, 2017
Answer: Breast Implant Removal and Fat Grafing Thanks for the great question. Fat transfer is still a procedure that is evolving and I don't think anyone actually has the experience or data to answer your question. It is true than implant removal can result in some scar tissue formation in the area of the former pocket and capsule and the skin and breast tissue does contract. I don't really think that fat grafting would prevent the former since the fat is not placed into the former pocket but rather into the overlying breast tissue. Fat grafting may prevent the latter but the contraction of breast tissue and skin is usually a desired thing after implant removal. It helps prevent sagging. To really answer your question, many women in your position would need to sign up for a study where immediate fat transfer was done on one side and delayed on the other side. I can assure you that this study would never make it through a review board and nobody would sign up for it!I require my implant removal patients to wait a minimum of three months prior to fat transfer. By three months the skin and breast tissue is usually done contracting and the layers of the breast and chest wall are usually solidly healed. Fat transfer is done into all layers of the chest wall and it's very important for everything to be healed down. The other procedure that can be very helpful after implant removal is a breast lift. I often do these at the time of implant removal if I am certain the patient will have a lot of sagging once the implants are out.
Helpful
July 12, 2017
Answer: Breast Implant Removal and Fat Grafing Thanks for the great question. Fat transfer is still a procedure that is evolving and I don't think anyone actually has the experience or data to answer your question. It is true than implant removal can result in some scar tissue formation in the area of the former pocket and capsule and the skin and breast tissue does contract. I don't really think that fat grafting would prevent the former since the fat is not placed into the former pocket but rather into the overlying breast tissue. Fat grafting may prevent the latter but the contraction of breast tissue and skin is usually a desired thing after implant removal. It helps prevent sagging. To really answer your question, many women in your position would need to sign up for a study where immediate fat transfer was done on one side and delayed on the other side. I can assure you that this study would never make it through a review board and nobody would sign up for it!I require my implant removal patients to wait a minimum of three months prior to fat transfer. By three months the skin and breast tissue is usually done contracting and the layers of the breast and chest wall are usually solidly healed. Fat transfer is done into all layers of the chest wall and it's very important for everything to be healed down. The other procedure that can be very helpful after implant removal is a breast lift. I often do these at the time of implant removal if I am certain the patient will have a lot of sagging once the implants are out.
Helpful
