Case #1383 · Brentwood, CA
Fat Grafting Breast Reconstruction
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This 68-year-old patient from Brentwood, CA had a previous breast reconstruction surgery and was unhappy with the results. Dr. Cassileth performed nipple reconstruction and added fat grafting to both breasts.
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
Guided return-to-activity plan with PT touchpoint at the 4-week visit.
Older patients benefit from a guided return-to-activity plan.
Pre-op preparation
What to do before surgery. Specific to this case.
- Aspirin, ibuprofen, vitamin E, and fish oil discontinued 14 days pre-op to reduce bruising risk. Acetaminophen is allowed.
- Full nicotine cessation 6 weeks pre- and post-op. This includes vapes and nicotine replacement products; the constriction effect is the same.
- Arrange button-front or zip-front tops for the first three weeks, overhead reaching is restricted. A drain holder or apron is provided.
- Confirm a driver for surgery day and a companion who can stay through the first night.
- Pre-op medical clearance from the patient's primary physician is required. Cardiology clearance added when indicated by history.
Recovery timeline
Milestones specific to this case. Individual recovery varies.
- Day 1–7
Light activity, hydration, and elevation. Expect peak swelling between days 3 and 5, then a gradual easing through the end of the week.
- Week 2
Walking distance doubles. Showering rules relax. Compression garments transition to the long-wear schedule.
- Week 4
Older patients benefit from a guided plan here, PT consult, gradual activity, and stretch goals through week 8.
- Week 6
The "back to normal" week for most patients. Final compression schedule transitions to optional.
- Month 3
Shape is 80–90 percent of final. Scars are still pink and will continue to lighten through month 12.
