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Breast Reconstruction Using Structural Fat Grafting

Women with breast cancer may undergo surgery as part of their treatment. Breast reconstruction surgery after a mastectomy or lumpectomy can restore a breast’s shape and appearance. In addition to more traditional reconstructive breast surgeries offered by UPMC’s Department of Plastic and Reconstructive Surgery, we offer structural fat grafting for breast reconstruction.

In structural fat grafting, a doctor harvests fat from one or more areas of your body and grafts it to another area. In this scenario, the doctor would move the fat to your breasts to create a smooth, more symmetrical, look. Because the procedure uses your own fat, it’s a more natural process than implants.

Is Fat Grafting Right for Me?

Structural fat grafting for breast reconstruction can improve the look left behind by previous procedures, including:

  • Lumpectomy
  • Mastectomy
  • Radiation therapy
  • TRAM flaps or similar surgeries

If you are healthy enough to undergo a surgical operation, you are most likely a candidate for this procedure. Structural fat grafting can create more symmetrical breasts and smooth over any scarring, dents, or other issues.

Before the Procedure

Before getting structural fat grafting for breast reconstruction, you will meet with the surgical team to learn about the procedure. A member of the team will examine you and take photos of your chest. Using the photos taken, the surgeon will work with you to create a tailored plan for your procedure. Part of this plan includes a color-coded blueprint of your procedure showing:

  • Where fat will be removed
  • Where the fat will be placed to create a smooth breast contour
  • Where the surgical team will make the tiny incisions to place the fat

Breast Reconstruction Fat Grafting Details

Your procedure will begin with the surgical team marking your body based on the agreed-upon blueprint. You will actively participate in this process.

Once all parties agree to the plan, the doctor will harvest fat from your body, from one or more areas including:

  • Abdomen
  • Arms
  • Flank area
  • Love handles
  • Inner thighs
  • Outer thighs

Your doctor will make sure the removal of fat leaves an enhanced area behind.

After harvesting the fat, the surgical team will put it through a centrifuge to refine and concentrate it. The process removes unwanted components like blood, oil, and water.

The doctor will then add the fat, little by little, to your breasts, sculpting to make sure you get the desired result.

Depending on the scope of the procedure, it can last anywhere from under an hour to five hours.

Type of Anesthesia

Most structural fat grafting takes place under general anesthesia. In more minor cases, doctors can use local anesthesia with sedation.

Recovery from Fat Grafting for Breast Reconstruction

Your recovery will likely depend on how much fat the surgical team harvests and how many areas they harvest it from. In general, the more fat and more areas used, the more uncomfortable your recovery will be.

Your breasts will be swollen and bruised, but you should experience little pain in that area. Most swelling in the region should subside within three weeks.

The donor sites will be bruised, swollen and sore, and swelling there can last longer – up to six months.

For the first three weeks, we advise not putting too much pressure on your breasts. That means avoiding sleeping on your stomach or doing rigorous upper-body exercises.

We advise taking about 10 days off of work after a bigger surgery, so you can comfortably ease back into your routine. You can begin light exercise 10 days to two weeks post-procedure.

Anticipated Results

The end results of your surgery may not be seen until months after the procedure, and the positive effects can continue for years after.

While fat can be easily damaged, structural fat grafting places it close to a blood supply to give it the best chance for survival. The surgery can fix problems left behind by previous procedures to give your breasts a better look.

Structural fat grafting can:

  • Restore breast volume
  • Soften the contours and hide the edges of breast implants
  • Shape breasts more naturally
  • Create cleavage
  • Improve the look of scars
  • Heal radiation-damaged skin

Risks

Complications are rare with structural fat grafting, but those that can occur include:

  • Bleeding
  • Infection
  • Scarring
  • Irregularities
  • Placing too much or too little fat

Scarring and calcification can occur with structural fat grafting, just as it can with other breast procedures.

Benefits of Breast Reconstruction Using Fat Grafting

Breast reconstruction using structural fat grafting can fix scarring and other skin damage from various procedures. It can create a more symmetrical look overall.

Other benefits of using structural fat grafting include:

  • A natural tissue: The fat is your own and cannot be rejected as a foreign tissue. Your own fat will feel like breast tissue.
  • Better shaping: The doctor places the fat precisely with tiny amounts at a time, making it easier to create a symmetrical look.
  • Reduced pain: Skin can become softer and more flexible after fat placement, leading to less pain and stiffness.
  • Long-lasting results: The softening benefits of stem cells can last for months or years after the procedure.