Will a mammogram compress fat after breast fat transfer? Should I be concerned about possible shape alteration or necrosis?

Question

I had a breast fat transfer a month ago following a partial mastectomy. I am due for regular mammogram screening in 3 months time, but am worried that the compression from the mammography will affect the breast shape or result in fat necrosis. I have read it takes 6 months for the fat to create its own blood supply. Should I consider a PET scan this time around only instead?

Daniel Barrett, MD · Answer

Dear electra03,
I understand your concern. It is best that you consult your plastic surgeon regarding post operative care and management (i.e including massage techniques and timing) specific to your case. Your surgeon knows your condition well and has preferences on when and what to use for faster healing and recovery. Post operative care and management depends on the type of surgery performed and the technique used during surgery among other factors.It is best, however, that you follow your plastic surgeon's advice on post operative care management for a smooth and faster healing and recovery.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Alan Gonzalez, MD, FACS · Answer

Hello @electra03, thank you for your question. A mammogram is a must-do test. Health takes precedence over any situation. In a mammogram, compression takes a few minutes. The breast will not be compressed all day. The main thing to consider is whether there are very recent scars rather than fat for this test. Your own doctor will advise you whether you should allow a little more time. Best wishes! Alan Gonzalez MD, FACS. International Federation for Adipose Therapeutics and Science” Member (IFATS), American Society of Plastic Surgery Member (ASPS), Colombian Society of Plastic Surgery member (SCCP)

Connie Hiers, MD, FACS · Answer

Once that fat has completely healed at about 6 months, then mammograms and other activity should not be a concern, and your added fat will act like the natural fat in your breast.

Mats Hagstrom, MD (license on probation) · Answer

The answer to your question should be answered by your plastic surgeon.
Each provider will have their own view on what’s appropriate and what’s not appropriate.
Grafted the tissues establish a new blood supply within the first week or the tissue will die.
That blood supply is gradually strengthened through increased neovascularization and the formation of scar tissue which holds tissue in place.
The most sensitive time for graft a tissue is within the first few weeks.
This is when grafted a tissue is most susceptible to not reestablishing a blood supply and becoming in the chronic.
At four weeks whatever fat is alive has a blood supply and there is no need for further differentiation.
The question is if the new blood supply is still fragile to pressure and could be damaged from an ultrasound.
Four weeks is probably relatively safe but I think most plastic surgeons would probably wait a little longer before putting grade pressure on your breast.
At three months it’s highly unlikely any external force will have any impact on the outcome of the procedure.
Results are typically final by three months and patients should not expect much change after that point.
Opinions will vary in regards to the timing of your ultrasound and it is probably inappropriate for us to give you medical recommendations without an established doctor patient relationship.
Follow up with your plastic surgeon. He or she are responsible for the outcome of your procedure and can give you the best advice.
Best,
Mats Hagstrom MD

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