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Cassileth Plastic Surgery

Case #1570 · Thousand Oaks, California

Fat Grafting Breast Reconstruction

Dr. Lisa Cassileth · Founder, Cassileth Plastic Surgery
Before
After
Before · FrontAfter · Front

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Additional views

Oblique
Case 1570 — Oblique before
Before — Oblique
Case 1570 — Oblique after
After — Oblique
Side
Case 1570 — Side before
Before — Side
Case 1570 — Side after
After — Side

This 37-year-old patient from Thousand Oaks, California was BRCA + and decided to undergo prophylactic bilateral mastectomies with one-stage breast reconstruction. 492 cc mid-profile implants were used. Patient subsequently had fat injections to both breasts at a second surgery.

Continued care

Recommended aftercare, skincare, and MedSpa services for Fat Grafting Breast Reconstruction.

Aftercare protocol
  • 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
Skincare
  • SkinCeuticals C E Ferulic on liposuction incision site scars
  • Body hydration protocol on donor sites
  • SPF 50+ on all scars for 12 months
MedSpa services
  • Hyperbaric oxygen therapy when recommended — supports graft survival
  • Indiba radiofrequency on donor sites
  • LED light therapy to reduce bruising
Specific to this case
  • Aftercare

    Bilateral HBOT protocol, 10–15 sessions over the first 6 weeks.

    Bilateral procedures heal more reliably with sustained HBOT.

  • Coordination

    BRCA pathway includes genetic counseling check-in for family planning and surveillance.

    BRCA+ patients benefit from coordinated long-term risk planning.

  • Skincare

    Sun avoidance and SPF protocol extended through month 12 to minimize scar hyperpigmentation.

    Younger skin pigments scars more reliably under sun exposure.

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.

  • Stop NSAIDs, aspirin, and high-dose fish oil two weeks before surgery; the surgical team provides a full medication list at the pre-op visit.
  • 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.
  • Day-of transport and an overnight companion (24 hours minimum) are required for discharge.

Recovery timeline

Milestones specific to this case. Individual recovery varies.

  1. Day 1–7

    Both sides healing in parallel means the early phase is quieter, short walks, full rest periods, and no driving until off pain medication.

  2. Week 2

    Walking distance doubles. Showering rules relax. Compression garments transition to the long-wear schedule.

  3. Week 4

    Most patients back to gym cardio at 50 percent intensity. Scar massage protocol begins. Driving restored if not already.

  4. Week 6

    The "back to normal" week for most patients. Final compression schedule transitions to optional.

  5. Month 3

    Tissue softens, scars begin to fade, and overall shape settles toward final. Scar maturation continues for another 6 months.

Considering this procedure?

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