Fat Grafting After Lumpectomy

BY LISA B. CASSILETH MD, FACS

When the amount of tissue that was removed in your lumpectomy caused a divot or an obvious difference in size between the breasts, we can do something to create a better match with the opposite breast. The best way to accomplish this is with fat grafting after lumpectomy, where your own natural tissue is used to recreate the volume.

We use liposuction to harvest healthy fatty tissue from other parts of the body (in areas where you have more fat than you’d like!) This tissue is processed into pure fat. We use highly specialized techniques to inject the fat. We inject tiny strips of the purified living fat cells into the breast tissue very carefully and methodically. This is designed to safely build volume. Sometimes this can take more than one procedure for larger divots, especially those that have been heavily radiated.

One of the nice benefits of fat grafting is that it is completely natural, it is a part of you. Once the fat has been placed, and is successfully living in the breast tissue, it will act just like fatty tissue anywhere in your body; if you gain or lose weight, you will gain or lose weight in the fat grafted tissue. It does not increase risk of cancer, and makes breast tissue easier to see at is is radiolucent and creates less dense tissue in the area grafted on mammogram. Finally, your natural fat contains mesenchymal stem cells, which replace the radiated defunct cells that were destroyed with radiation.

We use liposuction to harvest healthy fatty tissue from other parts of the body (in areas where you have more fat than you’d like!) This tissue is processed into pure fat. We use highly specialized techniques to inject the fat. We inject tiny strips of the purified living fat cells into the breast tissue very carefully and methodically. This is designed to safely build volume. Sometimes this can take more than one procedure for larger divots, especially those that have been heavily radiated.

If the proper technique isn’t used, it can result in fat necrosis, where the fat deposited outstrips the available blood supply. Our over 15 year experience with high volume fat grafting minimizes the risks of fat necrosis by ensuring safe fat placement to make up for missing, scarred, or radiated tissue.

How Does Fat Grafting for Breast Reconstruction Work?

Fat grafting is used in two ways for breast reconstruction:

Post lumpectomy – fat grafting after lumpectomy is a reconstructive procedure where fat can be injected into the divot that resulted from the oncological surgeon removing suspicious or dangerous tissue.
Post mastectomy and One-Stage Breast Reconstruction – during a secondary surgery after mastectomy, fat can be injected around the breast implant to give patients a natural look and improving warmth and appearance.

With the patient’s input, the doctor chooses a donor site, usually whatever fat is hard to get rid of with weight loss and undesirable. The fat is then removed from the area with a special liposuction technique that prevents the living fat cells from being destroyed. The suctioned fluid is processed into pure fat, which can be selected to create higher enriched stem cell concentrations. Stem cells have unique rejuvenating features, can enhance both the healing and beauty of your final result and are always recommended when the breast has been radiated.

The surgeon then skillfully and meticulously places hundreds of tiny strips of injected fat into the breast site using an instrument called a cannula. This technique prevents bleeding from the small vessels in and around the tissue, distributes the fat evenly around the tissue to prevent crowding, and therefore thereby preventing death of the transferred fat cells (fat necrosis). The fat is then incorporated within the existing matrix of adipose (fat) tissue and the breasts enlarge ‘naturally’.

Benefits and Results of Fat Grafting After Lumpectomy​

Most patients can expect to retain anywhere from 50-100% of the fat transferred. The fat that does successfully take is permanent. There are no incisions made to the breast. Instead, small access marks are made with a needle and heal with little to no scar. Patients also benefit by gaining a trimmer, slimmer area of the body from where the fat was harvested. There are small incisions needed at the fat donor site to harvest the fat, but they are well-hidden and not usually longer then 3mm.

Most patients can expect to retain anywhere from 50-100% of the fat transferred. The fat that does successfully take is permanent. There are no incisions made to the breast. Instead, small access marks are made with a needle and heal with little to no scar. Patients also benefit by gaining a trimmer, slimmer area of the body from where the fat was harvested. There are small incisions needed at the fat donor site to harvest the fat, but they are well-hidden and not usually longer then 3mm.

After your surgery you can expect mild to moderate swelling and bruising of both the breasts and the area from which the fat was harvested. There is usually very little discomfort of the breast after fat grafting and mild to moderate discomfort to the fat harvest site from the liposuction. You will be provided with the proper compression garment to minimize swelling of the fat harvest area.

Because the fat transferred to the breast consists of live cells, you will want to avoid any compression of the breasts for at least 2 weeks to allow the new cells to become integrated into the existing tissue. For this reason, we do not place you in a tight post-operative bra. You will want to avoid sleeping on your stomach or any other activity that would put direct pressure on your breasts. Most patients find they can return to work in 3-5 days for more sedentary jobs and a week for work that requires more movement.

To find out more about the fat grafting after lumpectomy options available to you, and how best to achieve the look that you want, call our office at 310.278.8200 to make an appointment for a consultation with one of our amazing surgeons  for your needs, or click here to schedule online.