Can fat transfer techniques be successfully applied for breast reconstruction? Or are there better methods out there?
What is Lipofilling and How is It Used for Breast Reconstruction?
Doctor Answers 27
Fat grafting has been shown to be a reasonable ancillary procedure to "touch-up" monor irregularities with breast reconstruction.
Fat transfer techniques can aid breast reconstruction
Fat transfer is a useful tool to optimize breast reconstruction outcomes. I recently fat grafted a patient's TRAM flap to improve volume, projection and shaping of the reconstructed breast. Insurance will pay for 'revision of breast reconstruction' and patients benefit from the liposuction required to obtain the fat for grafting. That's a double bonus for the patient !
Fat grafting in breast reconstruction
Fat grafting is often used in breast reconstruction for two main reasons -
- To correct the "shelf" that occurs between the chest wall and the upper pole of the implant
- To correct contour irregularities around the implant (palpable ripples, thin areas of skin, etc.)
The fat is removed from another area of your body (abdomen, thighs, hips) and is processed to isolate the fat cells. These fat cells are then injected into the area you wish to fill. Depending on technique, a percentage (the higher the better) of this transplanted fat will "take" or live and thus correct the deformity. Sometimes, more than one surgery is required to correct an area.
Some insurance companies deem this procedure as "investigational" and will not pay for it. It is important to discuss this with your surgeon prior to undergoing fat transfer. Other options include using dermal fat grafts (leaving fat attached to skin and transplanting as a single unit) and dermal matrices such as Alloderm.
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Lipofilling or fat transfer can be very useful in breast reconstruction.
Fat transfer is not the primary technique in breast recostruction, but we often use it to add finesse and a more natural look AROUND the main reconstruction.
The main breast reconstruction is done with an implant or a flap. But there can be hollows or defects from the mastectomy around the implant or the flap. This is where filling in with fat injections can turn a good result into a great result.
Breast enhancement using fat grafting
Fat grafting to breast for reconstructive purposes is ideally used as an adjunct in the following scenarios:
1. Augment and contour a breast reconstructed with autologous flaps (DIEP, GAP, etc...)
2. Contour the skin and remove ripples and irregularities after implant reconstruction.
Fat grafting used as a primary measure for reconstruction is not ideal and can cause complications.
Fat transfer for breast reconstruction
Yes, fat transfer techniques can be successfully applied for breast reconstruction, but 30-50% of the fat will be resorbed after transfer. Thus, when fat transfer alone is used for breast reconstruction, it is often necessary to undergo multiple surgeries to obtain adequate volume.
If you want to use your own tissue for a natural method of breast reconstruction, the better method is autologous tissue perforator flap breast reconstruction. While perforator flap breast reconstruction is a bigger surgery, it takes excess tissue from one part of the body with its own blood supply so that all of the tissue survives in the breast reconstruction. You can then use fat transfer in a second stage to shape and mold the details of the breast form.
Yes, indeed, lipofilling, or taking fat using liposuction from one area of the body (flanks, thighs, for instance) and placing the fat in the areas the breast for reconstruction is very commonly done- a portion of the fat does become absorbed by the body and so it is important to review what areas realistically can be treated ..
Lipofilling allows fine tuning of reconstructed breast contour
Fat transfer for breast reconstruction
Hope this helps
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