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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 transfer is a great adjunct to breast reconstruction. It can help with autologous flaps to add volume to certain areas as well as implants where there maybe some rippling. Generally fat transfer maybe needed more than once to get the desired outcome and the patient will benefit by getting rid of unwanted fat in certain areas. Its a win- win for the patient.Hope this helps
Fat transfer can be good options for small breasts. For medium to large breasts, multiple sessions would be required. Fat grafting can also help touch up contour issues with implants or autologous reconstructions(DIEP, Latissimus, TDAP).
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 is a technique that allows the reconstructive surgeon to harvest fat cells using liposuction from an area of excess. These fat cells are then purified and may be reinjected, or grafted, into areas of deficiency. Often these areas include the upper and inner aspect of the breast, the cleavage area, that is difficult to fill naturally with an implant. Lipofilling allows a surgeon to fill focal deficits in these and other aspects of the breast to yield the most natural looking result.
Fat transfer is a great procedure in breast reconstruction especially in the setting of a lumpectomy defect. It also works quite nicely to conceal an implant that has little coverage if the mastectomy resulted in thin skin. It can also be used for reconstructing a breast from "scratch". This is less typically used as the skin does not easily stretch enough to accommodate this. Multiple surgeries can be used to slowly increase size. Some surgeons would suggest the Bravia system to be a solution to that problem. The long and short of it is that you should speak to a surgeon that offers fat transfer as well as all other forms of reconstruction. They will best be able to advise you on your options as well as the potential risks with each.
One of the newest techniques for breast reconstruction involve utilization of the exciting benefits of fat grafting. Much research has been put forth into plastic surgery for harvesting of fat and its potential as stem cells. Fat grafting and transfer has been utilized both for breast augmentation but also in breast reconstruction for contouring of the breast after implant-based and flap-based reconstruction with excellent results. After a lumpectomy or mastectomy, an innovative technique which has been implemented is performing this fat grafting and transfer technique to completely reconstruct a breast. This would involve no other scars or incisions, no foreign bodies or implants, and no complex flap procedures. Plus, additional benefits to the breast reconstruction include as close to normal sensation of the breasts along with the benefit of liposuction to harvest the fat from wherever there is spare fat! Working with your breast surgeon during the oncologic procedure for your breast, some fat is harvested during the same surgery, which in turn is placed back into the breast area. This will give a small breast mound immediately after the procedure. An external expander device is then used for several weeks after the initial procedure while you are sleeping. The expander will have the same befits as the internal tissue expander, owever it is simply worn on the outside as a vest, without having an implanted prosthetic. It has been shown to increase vascualrity, increase blood supply (important for radiated breasts especially), as well as expand the breast framework for which the fat will be placed in the future. Once adequate expansion has been obtained after several weeks of wearing the external expander vest, a simple outpatient procedure will be performed in which liposuction will be performed from areas where you have excess fat. Instead of wasting this fat, it will be harvested, washed, and then transferred back directly into the breast to give the additional volume to reconstruct the breast. The liposuction may be performed from the abdomen, flanks, hips, thighs, buttocks, etc., until enough fat has been obtained to give adequate volume for your reconstructed breast. Multiple micro-fat grafts will then be placed throughout the expanded breast framework within its well-vascularized bed. Sometimes this will take a few small outpatient procedures, separated by several weeks, to obtain the results. Fat grafting allows precise placement of where the fat should go in order to perfectly contour the breast shape. The newly-reconstructed breast mound has now been recreated with the use of only your own fat via liposuction with the hopes for a breast mound that looks and feels much like a "normal" breast. The results thus far have been superb and patients have raved about their overall results. Have a discussion about ALL options available for breast reconstruction with your plastic surgeon, and together, decide which breast reconstruction technique is best for you.
Lipofilling or Fat Transfer procedures are effective secondary adjunctive procedures to add volume and help make your breasts reconstruction more symmetric. In some cases with smaller breasts this technique can be used for primary reconstruction.
Fat transfer or fat augmentation is useful as an ancillary procedure to recontour irregularities in the breast during reconstruction. The downsides of injecting fat into the breast after breast cancer diagnosis is still unclear and unproven.
Fat transfer can be really useful in breast reconstruction for some patients. Obviously it is not possible to use fat transfer as the only means of reconstruction. Fat transfer is most useful for filling in smaller asymmetries that may still exist following your reconstruction procedures.
