Case #1385 · San Diego, California
Fat Grafting Breast Reconstruction
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This 52-year-old patient from San Diego, California was presented with bilateral tissue expander reconstruction from a previous surgery with another surgeon 5 years ago. Dr. Cassileth performed bilateral fat grafting to breasts to create fuller breasts and improve the appearance
Continued care
Recommended aftercare, skincare, and MedSpa services for Fat Grafting Breast Reconstruction.
- No pressure on the reconstructed breast for 3 weeks — graft survival depends on tissue contact preservation
- No bra with underwire for 6 weeks
- Walking encouraged; cardio at week 4
- Liposuction donor sites: compression garment for 4–6 weeks
- Hyperbaric Oxygen Therapy to support healing when recommended
- SkinCeuticals C E Ferulic on liposuction incision site scars
- Body hydration protocol on donor sites
- SPF 50+ on all scars for 12 months
- Hyperbaric oxygen therapy when recommended — supports graft survival
- Indiba radiofrequency on donor sites
- LED light therapy to reduce bruising
- Aftercare
Bilateral HBOT protocol, 10–15 sessions over the first 6 weeks.
Bilateral procedures heal more reliably with sustained HBOT.
Why this approach
The decisions that shaped this surgical plan.
- Both sides treated in the same session, symmetric planning, identical tissue handling, and matched final contour are easier to achieve in one operative window than in two.
Pre-op preparation
What to do before surgery. Specific to this case.
- Discontinue blood thinners (NSAIDs, aspirin, fish oil, vitamin E) two weeks out. Acetaminophen remains safe; the full list is reviewed at pre-op.
- Full nicotine cessation 6 weeks pre- and post-op. This includes vapes and nicotine replacement products; the constriction effect is the same.
- No overhead clothing for 3 weeks. Stock front-zip tops, supportive sports bras (post-clearance), and the drain pouches we provide.
- Confirm a driver for surgery day and a companion who can stay through the first night.
Recovery timeline
Milestones specific to this case. Individual recovery varies.
- Day 1–7
Bilateral healing takes a slower start. Expect more chest-wall fatigue through day 5 and a stricter no-lifting rule for the first 10 days.
- Week 2
Patients off prescription pain medication, walking 1–2 miles daily, and back to most light household activity.
- Week 4
Light cardio and most desk-work activities cleared. Lifting limit increases to 15 lb. Scar massage typically starts now.
- Week 6
Most physical restrictions lift. Return to strength training, full-impact cardio, and overhead lifting.
- Month 3
Most patients consider this the "final result emerges" milestone. The remaining 10 percent of refinement plays out through month 6.
