When the amount of tissue that is being removed causes a divot or an obvious difference in size between the breasts, we have to 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 droplets of the purified living fat cells into the breast tissue very carefully and methodically. This is designed to slowly build volume. Sometimes this can take more than one procedure for larger divots that have been heavily radiated.
If the proper technique isn’t used, it can result in too much of the fatty tissue being deposited in one spot, which will cause it to have low blood supply and die. This dead fat can cause inflammation and scar tissue.
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.
Lumpectomy and radiation can cause a divot, or loss in breast volume. We perform fat grafting after a lumpectomy to restore volume to the breasts and make them symmetrical.
When a woman undergoes surgery for breast cancer, she can expect to experience the removal of some or all of her breast tissue. For many of these women, an important part of her recovery and reclamation of her normal life is achieved by breast reconstruction. And whether it is performed as part of the original cancer surgery, or later after her cancer treatment has been completed, breast reconstruction using fat grafting enhances the shape of the breast, producing natural and attractive results using the material most compatible with a woman's body: her own fat cells.
Read more about Breast Augmentation with Fat Grafting
Fat transfers have a long history in medicine and have been performed for over a century. For years, doctors have been using patients' own fat to restore areas of the body affected by illness or injury, or to improve the appearance of certain trouble spots that deflate with age. Successful fat grafting, however, is very technique dependent. There is a specific way that the fat must be harvested, processed, and transferred to the new area as it is moving living cells to a new area.
Beverly Hills plastic surgeon Dr. Lisa Cassileth, an innovator in breast reconstruction surgery, understands the difficulties faced by women undergoing breast cancer treatment extremely well. Each year, she performs hundreds of breast reconstruction surgeries, many involving fat grafting procedures.
Fat grafting is used in two ways for breast reconstruction:
When a patient desires fat transfer for breast reconstruction, with the patient’s input Dr. Cassileth chooses a donor site, usually tummy, thighs, or flanks (love handles). 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.
Beverly Hills plastic surgeon Dr. Cassileth then skillfully and meticulously injects hundreds of tiny individual fat droplets into the breast site using an instrument called a cannula. This technique prevents bleeding from the small vessels in and around the tissue, 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'.
Dr. Cassileth was the voice of reason in a time of trauma and the unknown. Finally, a doctor who understood me! She even gave me options for the type of implants, and we talked about a tram flap vs expanders and fat grafting. She also constructed my nipples, and they look 100% real and natural!"
Most patients can expect to retain anywhere from 50-80% of the fat transferred. The fat that does successfully take is permanent. There are no incisions made to the breast. Instead, small ports 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 two 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 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 the best Beverly Hills plastic surgeon Dr. Cassileth, or click here to schedule online.