Large volume fat transfer or grafting may be used to reconstruct the entire breast. Fat is usually collected with the use of liposuction from your abdomen, hips or thighs and placed to form a new breast mound. Sometimes multiple sessions are needed, however, there is minimal downtime, quick recovery and minimal scaring. Fat transfer on a smaller scale may also be used to supplement other reconstructive techniques to blend the contours of your breasts in order to achieve the most natural appearing result.
Fat transfer breast reconstruction may be a good option for you depending on your lifestyle and desires, your body limitations and the condition of your breast(s). An understanding of the alternatives, risks and the limitations of this technique is important in making the decision that is right for you.
Fat Transfer Reconstruction Techniques
Before fat grafting, liposuction is performed and fat is removed from your abdomen, buttocks, and thighs or wherever else you may have excess. This fat is carefully handled and prepared to maximize fat survival and preserve stem cells and any other beneficial growth factors that may be present. This is then injected through small needle holes into the breast area. Recovery is similar to any liposuction procedure and patients often go home the same day. This process may need to be repeated once or twice until the desired breast size is reached. There is minimal scarring and results often appear very natural. Since healthy blood vessels are important for fat graft survival and adequate healing, fat transfer breast reconstruction is not usually recommended for women with diabetes, vascular disease, or to smokers.
Your visit with Dr. Hamawy will determine if you are a good candidate. If you are in good physical health and your breast surgeon has agreed to the timing of your reconstruction, then a fat graft breast reconstruction may be a good choice for you. Before you decide on what type of surgery you want, think carefully about your expectations and plastic surgery options, and discuss them with Dr. Hamawy.
The final stage of breast reconstruction is a making a nipple. A nipple reconstruction is performed as an outpatient procedure using your own tissue once the breast mound has been formed. The areola and nipple are then tattooed in the office after the nipple reconstruction has completely healed.
During your first visit, Dr. Hamawy will examine you and determine your general health. Be prepared to discuss your medical history including any medical conditions, allergies, treatments you have received, prior surgeries including breast biopsies, and any medications that you currently take. It is important for you to provide complete information. Dr. Hamawy is concerned about your health and safety and, depending on your medical status, may ask for additional evaluations before proceeding with surgery.
You will learn about the procedure, its limitations and risks, and discuss your needs and concerns. He will explain all your options for breast reconstruction, including tissue flap reconstruction and implant reconstruction. He will also discuss the risks and benefits of each procedure.
After the discussion you should be able to decide together which surgical techniques are the most appropriate for you based on your desires, your physical limitations and the condition of your breast(s). Dr. Hamawy will examine your body and will consider such factors as the quality of your skin tone and the contour and fat distribution over your body. After your consultation, photographs will be taken for your medical record.
The Day of Surgery
Before surgery, you will be given medicine to lessen the anxiety and pain. General anesthesia is typically used, so you will be completely asleep for your breast reconstruction. You will meet your anesthetist before your procedure and he or she will answer any questions you may have about your anesthesia. The surgery usually takes 2-4 hours depending on the amount of fat to be harvested and if both breasts are being grafted. After surgery, you will awake in the recovery area where you will be closely monitored before being discharged home the same day.
You will have some discomfort and/or pain following surgery. When you are discharged, you will be given prescriptions for pain medication. A compression garment will also be worn over the areas that were liposuctioned. Plan on having limited physical activity for up to three weeks.
Your follow-up visits will usually start in one week following your surgery for a checkup. During your postoperative visits, Dr. Hamawy will review activity limitations, incision care and any concerns you may have. Following this visit, you will return in approximately 3 weeks and 6 weeks. If additional sessions are required, they will be planned at this time. After you have recovered from your final fat transfer session, you will be seen at 3 weeks, 6 weeks, 3 months, 6 months then every year thereafter. Surgical revisions and nipple reconstruction may be necessary to complete the final process.
LENGTH: Up to 2-4 hours
NUMBER OF SURGERIES FOR COMPLETE RECONSTRUCTION: 2-3 surgeries over a six month period
SIDE EFFECTS: Bruising, swelling
RISKS: Bleeding, infection, asymmetry, poor fat survival
RECOVERY: Return to work: 1 week – Swelling completely resolved: 8-12 weeks