Restrictions after Breast Fat Transfer? 6 weeks or 3 months?

Question

Some surgeons have very strict guidelines about post-op care for breast fat transfer citing that it takes 3 months for the fat cells to stabilize. No drinking, no smoking, no compression, and no exercise for 3 months. My surgeon is lenient and tells me I have 0 restrictions after 6 weeks. I want to retain as much fat as possible but also live my life. I have a vacation planned at 8 weeks :( Is there any hard truth to the 3 months rule or is it just an extra precaution?

Daniel Barrett, MD · Answer

Dear volinna,
every plastic surgeon has his own postoperative protocol which he recommends to his patients. I would suggest you to discuss this with your plastic surgeon.
Daniel Barrett, MDCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery

Ronald J. Edelson, MD · Answer

Despite all the things you may have been told about fat transfer to the breast nobody knows what will make one fat transfer more successful than another. It is a hit it miss guessing game at best. For this reason I simply do not recommend the procedure. It has a poor track record

Connie Hiers, MD, FACS · Answer

I place my patients on restrictions up to 3 months for it takes that much time until the transferred fat grafts are stable to handle pressure and jumping around. It all depends upon what you prefer either to "live my life" or have a successful fat transfer.  You can always postpone your surgery until after your vacation.

Elizabeth A. Killion, MD · Answer

I tell my patients 6 weeks. If I transfer a higher amount I go with 8 weeks. Hope this helps and good luck!

Mats Hagstrom, MD (license on probation) · Answer

In my opinion, there are only two variables that matter when it comes to fat transfer procedures. The first is the patient for the procedure in the first place. A lot of this has to do with the quantity and quality host tissue to support the grafted fats.
The second variable is the amount of fat grafting, and a technique used. Ideally fat should be grafted in the most stratified fashion possible. Place in grafted fat on top of grafted fat will lead to an increase in fat loss or less retention of grafted fat.
Neovascularization of grafted tissue happens relatively quickly. In our practice, which typically allow patients to go back to low impact normal activities in 2 to 3 weeks.
There’s no clinical evidence that long-term restrictions have any impact on grafted fat.
In my opinion, it’s far more important to pick the most talented and experience provider, and with that calms having a clear understanding of what the procedure can, and cannot accomplish long-term.
Unfortunately, before and after pictures can easily be deceptive when it comes to fat transfer. Long-term results are radically different than short term results when it comes to this procedure. Providers tempted to put their best foot forward may be showing pictures taken less than 3 to 6 months from the date of the procedure.
Defined the best provider I suggest patients have multiple in person consultations. During each consultation, and reviewing before, and after pictures, confirm with total certainty, the timeframe of when after pictures were taken.
I do not recommend patients deviate from each providers recommended postoperative protocol. Doing so would be inappropriate.
I don’t think patients should choose providers based on the providers recommended postoperative protocol, but rather choose providers based on a proven track record of successful long-term outcomes, as indicated by having a virtually endless collection of quality before and after pictures all confirmed with appropriate time frames of when after pictures were taken.
To find the right provider, I suggest patients have multiple in person consultations. During each consultation, ask each provider to open up their portfolio and show you their entire collection of before, and after pictures of a previous patient with similar body characteristics to your own. 
An experienced provider should have no difficulty showing you the before, and after pictures of at least 50 previous patients. Being shown a handful of preselected images, representing the best results of a providers career is insufficient to get a clear understanding of what average results look like in the hands of each provider.
Recognize that when you have fat transfer, you’re always having two procedures done at the same time. I cannot emphasize enough the importance of properly vetting providers for both Liposuction and fat transfer skills.
Delivering consistent quality, liposuction and fat transfer results is more difficult than most people realize. The number of plastic surgeons who truly mastered these procedures are in a small minority. These procedures have massive variations in outcome depending on who you choose as your provider. Being board-certified in plastic surgery is no guarantee that somebody has mastered any one single procedure especially not Liposuction and fat transfer.
Most plastic surgeons think they’re better at liposuction than they actually are.
This procedure has a significant variation in outcome, including the possibility of patients being left permanently disfigured from poorly done work. This includes operations done by board-certified plastic surgeons with years of experience.
The importance of provider selection it cannot be overemphasized. The biggest mistake patients make is not having enough consultations.
 There’s no correct number of consultations needed to find the right provider. The more consultations you have the more likely you are to find the best provider for your needs.
Considering how much variation there is in both Liposuction and fat, transfer skill among plastic surgeons, I recommend patients consider having at least five in person, consultations before considering scheduling surgery.
Best,
Mats Hagstrom, MD

Restrictions after Breast Fat Transfer? 6 weeks or 3 months?

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