Fat grafting, also called autologous fat transfer, is a breast augmentation procedure often used as an adjunct to breast reconstruction.

During this procedure, a surgeon takes fat from a donor site, liquefies it, and injects it back into the breast to shape it. This process removes the need for artificial implants and can have a shorter, less intensive recovery period than other reconstruction options.

This article will examine the process of fat grafting for breast reconstruction and the benefits, risks, costs, and anticipated results.

It is important to speak with a doctor about the procedure, how to prepare for it, and the risks involved.

In some instances, doctors may recommend breast tissue expansion before surgery. One option is the use of an internal inflation device. While the implantation of an internal spacing apparatus does require an invasive procedure, they have been shown to yield positive results in fat grafting.

Fat grafting 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.

Creating a natural breast shape may involve multiple fat grafting procedures over a period of time, in intervals of 3 to 6 months. This is due to the body absorbing between 10 to 90% of the transferred fat.

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:

  • bruising
  • swelling
  • scabbing at the donor and recipient sites
  • pink or reddish discharge at the incision sites

If possible, people should shower instead of bathe and avoid getting the wound wet.

To help relieve pain, people can take over-the-counter pain relievers and the medications the surgeon has prescribed.

Fat grafting is a safe and effective method of breast reconstruction or augmentation. As a minimally invasive procedure, it typically carries a shorter recovery time than invasive implant procedures. Breasts reconstructed via fat grafting may feel softer and more natural than those reconstructed with implants.

However, results may take time, as a person may require several fat grafting procedures to achieve the desired look.

Is it permanent?

In many cases, the body may reabsorb some of the fat over time, losing 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.

As with any surgery, there are risks to far grafting, including:

  • infection
  • the formation of cysts
  • microcalcification, or calcium deposits
  • migration of fat cells from where they are injected to outside of the breast area
  • the risk of necrosis, which is when some of the fat dies

Necrosis

In fat grafting, there is a risk that some of the injected fatty tissue may die and break down, in a process known as necrosis.

People who have a large amount of tissue injected into the breast have a higher risk of necrosis.

Fat necrosis causes scar tissue buildup that may form lumps, or nodules, that can be mistaken for breast cancer. However, necrosis in injected tissue does not increase a person’s risk of breast cancer.

Doctors are often able to remove scar tissue from necrosis through excision or aspiration.

After a time, there is also a risk that the body may start to reabsorb the fat deposits, reducing their volume.

The Women’s Health and Cancer Rights Act is a federal law that requires most group insurance plans to cover the cost of mastectomies and breast reconstruction.

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 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 – although this is rare.

It is important to note that there has not been enough long-term research to determine how long this procedure’s results 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.