Is there an alternative to fat grafting?

Alibeths

Seems like such a big surgery? I need my upper pole filled out. I thought i remembered reading that they can use alloderm or even something else? HELP!!!!

SpecialK

alibeths - I have had fat grafting several times - for different reasons.  The first was to fill out the upper poles about three years ago. I have a bony chest and the implants looked obvious, and my BS did a great job of excavating the breast tissue all the way up, so I had big divots above the coconutty looking implants.  My PS layered fat in above in the hollows, with none over the implants themselves, and greatly softened the step off and improved the situation really dramatically - an excellent result.  I had that surgery in an outpatient center, with propofol.  I was in and out in a couple of hours, no grogginess from anesthesia.  I had a significant amount of fat removed and applied, but I did not feel like it was a big surgery.  I had soreness afterward, only in the donor area, but I drove the following week, and surgery was on a Friday.  I currently do not have an implant on the left (non-cancer) side due to skin healing issues from a repair of bilat allograft slings done 18 months ago, and have had two small grafts done to bulk up the skin there - as is starting to be done for radiated skin to prepare it for recon.  Both of those surgeries involved skin repair, but also smaller amounts of fat grafting.  No pain at the graft site, and very little at the donor site - directly related to the volume of fat harvested - which was several hundred cc's.  Ask your PS how much fat he/she thinks would be needed, but I did not feel that any of these three procedures were difficult surgeries with long recoveries.

Elizabethaw

I'm 7 weeks out from fat grafting to fix rippling, and I didn't find it a terrible surgery either. The donor areas were really sore for the first 3-4 days (but only when getting up and down), and I did take a week off work, but it was not a big deal. I didn't need any narcotics--a little advil was fine. I'd think that Alloderm would be worse--it's a sheet of tissue that would need to be placed under the skin, and I'd assume that would require more incisions. Fat grafting involves little bitty incisions--mine look like mosquito bites on the donor areas and you can't see any mark where my surgeon injected the fat into the breast area.

Lily55

Alloderm is tissue from cadavers, no way would I do that..........

SpecialK

lily - not all allograft material is from cadavers, some is bovine, some porcine, and some - TIGR mesh specifically - is completely synthetic.

Alibeths

do you see a big deference from the fat grafting

SpecialK

alibeths - The initial fat grafting I had done made a huge difference at the graft site - I went from looking like I had a coconut under my skin with a huge dent above it to looking like I had a natural breast.  I did see a difference at the donor site also but it was less dramatic. Generally, the PS may only take the amount of fat needed for the graft so as to avoid any appearance of a cosmetic procedure to insurance, which can give them a reason to deny coverage as a breast revision.  So, depending on what is needed for the graft some people see a difference at the donor site, some don't.

exbrnxgrl

I also don't think, though I could be wrong, that alloderm is not used to fill in areas but rather it serves as a support. It is used for many things, other than recon. In recon, it is used to fashion a sling like support under the reconstructed breast, like an internal bra. The tissue used,regardless of origin, is thoroughly sanitized and hygienic. I have alloderm "slings". No problem, no yuck factor and cosmetically great results

SpecialK

exbrnxgirl - I would agree that allograft material is not used to "fill in" but it can be used, in addition to making slings for support of implants, to cover thin areas or dents in other parts of the breast.  Sometimes in the excavation and removal of breast tissue there are uneven or thin skinned areas that require a "patch" of sorts under the skin.  It would be similar to a worn knee on a pair of jeans, or a thin area on the bottom of a shoe, and dermal matrix can be used for this to shore up the area.

exbrnxgrl

Thanks, specialk! I also want to add, for those who are not comfortable with the idea of cadaver tissue, that the whole range of possible transplants would not exist without tissue and organs from cadavers. I am grateful to those who choose tissue/organ donation

Free123

Alibeths, I had fat-grafting last week with my exchange surgery and did not find it difficult at all, and as of now it looks amazing. I will have to wait several weeks to make sure it all "takes" but it sure looks good now.

Did have some pain at donor site- my inner and outer thighs- but the pain was only in the act of standing up or sitting- once I get situated I felt nothing. Ten days out and I am pain-free. My PS did the fat-grafting to fil in my upper poles also like SpecialK. I can't remember her exact words but when she explained the possibility of using Alloderm it sounded like there were more risks involved as far as effectiveness and recovery when using it for fill-in. I could tell she thought fat-grafting was simpler and more effective. She did use Alloderm in my original DBMX surgery and TE placement. Had no trouble whatsoever and never gave a second thought to what it is made of. Some stuff you just can't think too hard about LOL!

Lily55

AS a long standing (decades) vegetarian, I would not accept any kind of Alloderm except guaranteed synthetic, and I am against testing on animals, paedophiles would be better or those on Death Row.....

exbrnxgrl

I know this is ot, but do vegetarians accept blood or blood products for medical reasons (in general, I realize everyone is different)?

So-Oly

I am healing from recon (expanders out, new implants, back lift, fat grafting.) it's my second reconstruction after the B Mas and node dissection) After all this surgery the fat grafting has been the easiest with some of the best results. Good luck!!