Fat grafting

Fat grafting, also called autologous fat transfer or lipomodelling, is emerging as a new breast reconstruction technique. The procedure involves taking fat from other parts of your body – usually your thighs, belly, and buttocks – by liposuction and injecting it into the breast area. Fat grafting can be used to reconstruct an entire breast or as a means of sculpting a breast reconstructed by other methods.

FAT GRAFTING FOR SCULPTING A RECONSTRUCTED BREAST

Use of Fat grafts can be a safe and effective method for sculpting and refining the results of breast reconstruction surgery. Plastic surgeons often use fat grafting as a contouring aid with implants and free flaps to improve the shape and symmetry of the reconstructed breasts. Complementary fat grafting can also give the breasts a more natural look and feel, resulting in higher patient satisfaction.

In addition, fat injections actually help radiated tissue, as radiation treatment often causes decreased blood flow and scarring in the tissue. Transferring new fat to this area can actually help increase circulation, soften the tissue and improve the quality of the skin.

FAT GRAFTING FOR RECONSTRUCTING

Compared to using fat grafts to sculpt a breast that’s been reconstructed through other methods, using fat grafts to reconstruct or augment a breast remains controversial. And even though fat grafting is slowly gaining acceptance within the medical profession, many cosmetic and plastic surgeons still won’t perform this surgery. These physicians argue that the procedure is not sufficiently reliable since fat injections have a high chance of being reabsorbed into the body or potentially calcifying into a hardened mass.

However, there’ve been great strides in fat grafting, such as a procedure in which an external tissue expander – called a Brava device – is worn for several weeks before and after the fat grafting. The Brava device is like a bra with plastic cones for cups. The cones put suction on the breast area to expand the tissue and create a matrix for the fat to live in. Wearing the Brava device seems to be important for the reconstructed breast to maintain its volume.

Depending on the size you would like your reconstructed breast to be, you may have to have multiple fat grafting procedures that are done over a period of 2 to 6 months. It’s also important to note that in many cases the fat injected into the breast area may be partly reabsorbed by the body over time and the breast may lose some volume. This is why some plastic surgeons initially may add more fat than you think you need.

Advantages

Using your own tissue instead of an implant

Fat is removed from an area where you don’t want it

Both the liposuction and the fat injections can be done with local anesthetic; they’re not major surgical procedures and involve only a few days recovery in most cases

Many women report that a fat-graft-reconstructed breast has sensation and feels soft, much like a natural, unreconstructed breast

Disadvantages

Depending on which surgeon you choose to do the procedure, you may be required to wear the Brava device or another type of external tissue expander for 4 or more weeks before the fat injections and for several weeks after

The injected fat may be reabsorbed by the body and you may lose some breast volume over time

Because some fat cells can stimulate cell growth, some doctors are concerned that fat injected into the breast area may cause dormant breast cancer cells to grow; but till now research hasn’t approved that this concern is valid

Some of the fat injected into the breast area may die (necrosis); symptoms of necrosis may include pain and bleeding, the skin turning dark blue or black, numbness, fever, and sores that ooze a bad-smelling discharge or pus