Those who have had a mastectomy may wish to undergo breast reconstruction. One way to accomplish this is through fat grafting, also called autologous fat transfer.
During this procedure, a surgeon takes fat from a donor site, liquefies it, and injects it back into the breast to shape it.
Although fat grafting for breast reconstruction is less invasive than other types of reconstruction, researchers have not been able to study it as long or as comprehensively as other types of breast reconstruction.
This article will examine the process of fat grafting for breast reconstruction and the benefits, risks, costs, and anticipated results.
In the past, surgeons have used fat grafting to alter the shape of the breast, filling in ripped or dimpled areas. However, more recently, surgeons have used it alongside other reconstructive techniques or as a stand-alone procedure to reconstruct the entire breast.
A surgeon can perform fat grafting for whole breast reconstruction or alongside breast conservation therapy.
During the procedure, the surgeon suctions fat from other areas of the body using liposuction. These areas can include the:
The surgeon then processes the fat and injects it into the breast area to create the shape of the breast.
Depending on what size the reconstructed breast will be, a person may require several fat grafting procedures over the course of months or years, according to Breastcancer.org.
Before undergoing the procedure, a person should speak with a doctor about the procedure and how to prepare for it. They should also ensure that they understand the risks involved and any aftercare instructions.
The procedure involves removing fat from other parts of the body and transferring it to the breast area. A surgeon will often do this using general anesthesia, which means that a person will not be awake for the procedure.
Creating a natural breast shape may involve multiple fat grafting procedures over a period of time, in intervals of
During the first procedure, the surgeon may inject the fat into the:
- pectoralis major muscle
- lateral thoracic fascia
- mastectomy flaps
After the procedure, surgical assistants place compression garments on the donor and placement sites.
A surgeon will provide clear instructions on what a person should do after the procedure.
There may be stitches at the site where the surgeon removed the fat, or donor sites, and where the surgeon placed the fat into the breast, or the recipient sites. There may be tape and gauze covering the stitches.
People may also experience:
- scabbing at the donor and recipient sites
- pink or reddish discharge at the incision sites
According to the National Health Service (NHS), a person should leave the original dressing on for 2 days, unless instructed otherwise. People should avoid removing the stitches or any tape covering them.
If possible, people should shower instead of bathe, and avoid getting the wound wet.
To help relieve any pain, a person can take over-the-counter pain relievers and the medications the surgeon has prescribed.
Fat grafting is best for people who have realistic expectations about proportionally sized breasts and want a natural-looking result.
Results may take some time to see, as a person may require several fat grafting procedures to achieve the desired look.
Is it permanent?
According to Breastcancer.org, in many cases, the body may reabsorb some of the fat over time, resulting in a loss of volume. For this reason, a surgeon may initially use more fat than a person needs, and people will require multiple procedures.
The benefits of fat grafting for breast reconstruction are as follows:
- It uses an individual’s own body tissue instead of placing a foreign item, such as an implant, into the body.
- It removes fat from an area a person may not want it.
- Breasts created with fat grafting may have some sensations and feel more natural.
Before opting for fat grafting, it is important to note that, as of yet, there have not been any large clinical studies with a long-term follow-up. This means that it is not possible to say how long the results will last.
Additionally, if the fat grafting is unsuccessful, a person may then not have enough sources of tissue to opt for flap reconstruction.
Other risks and considerations include:
- requiring multiple fat grafting sessions
- the reabsorption of fat, resulting in a loss of volume
- the risk of necrosis, which is when some of the fat dies
Fat necrosis can cause lumps that a person may feel in the soft tissues. This may cause people to be concerned that the cancer has returned.
Researchers are also concerned that the fat that is injected into the breast can cause dormant breast cancer cells to grow. However, more research is required to confirm this.
Risks of surgery can include:
Medicare also covers breast reconstructive procedures.
For those without insurance, Medicaid may be an option. However, its coverage varies by state.
People should ask the plastic surgeon’s office if they offer patient financial plans. This can allow a person to cover the cost over a period of time.
The Alliance in Reconstructive Surgery foundation provides grants to those who are unable to cover the cost of reconstructive surgery. A person can apply for a grant here.
Fat grafting for breast reconstruction involves taking fat from one area of the body, typically the stomach, thighs, or buttocks, and injecting it into the breast.
Surgeons have used fat grafting as a complementary procedure to other forms of breast reconstruction. More recently, surgeons have been using fat grafting as a stand-alone procedure to reconstruct the whole breast.
It is important to note that there has not been enough long-term research to determine how long the results of this procedure last.
A person should speak with a healthcare professional about the benefits and risks of the procedure to determine the best course of breast reconstruction for them.