Fat grafting reconstruction after a single mastectomy?

BPXDomino

Hello everyone - new to the community and looking for some advice regarding reconstruction. I am leaning towards reconstruction with fat grafting instead of having an implant because I like the idea of not introducing a foreign object into my body permanently. I have so many questions though and am hoping to find someone else here who has gone through this to hear exactly what you did and what you would recommend!

Some background: After I was diagnosed with a triple negative cancer, the suggestion of bilateral mastectomy was presented to me. However, my surgeon helped me come to the conclusion that it might be best just to go with a single mastectomy for now to avoid introducing any complications from removal of the healthy breast that could delay chemotherapy. I opted for immediate reconstruction with tissue expanders, thinking at the time I would get an implant that would match the size of my right breast.

I only recently learned about fat grafting instead of using an implant. I think that's what I want to do.

I also don't know if matching my right breast in size is what I should go for, because if I have a choice in the matter, I'd prefer to go smaller. But then I'm going to be lopsided. I keep thinking that maybe I shouldn't think that way if I end up having the healthy breast removed down the road, but... I really don't think I'm going to do that. My mother had breast cancer in her 30's like me and she has been doing just fine all these years later. My grandmother also had breast cancer around the same time (she was in her 60's) and is still going strong at 90 years old, no other problems. I am hopeful I will have the same outcomes and am thinking I'd rather not go through another mastectomy if I can avoid it.

But of course I don't want to be.. asymmetrical... either. I'm wondering if I just have to be prepared to be unbalanced anyway with fat grafting, as I understand some of the fat gets reabsorbed after surgery and it could take multiple surgeries to get the right outcomes.

So if you've had a single mastectomy and had this done, what was your experience? Many thanks for any advice you can offer!

Moderators

Hi BPXDomino, and welcome to Breastcancer.org,

We really appreciate your posting -- you're sure to find our incredible Community a wonderful space for information, advice and support!

While you wait for the ever-helpful responses from our awesome members, you may want to check out the main Breastcancer.org site's page from the extensive Breast Reconstruction section on Altering the Opposite Breast.

We hope this helps and we look forward to hearing more from you soon!

--The Mods

Lula73

There are 2 options- autologous flap reconstruction where they take tissue from your tummy, butt, hips, etc and transplant the tissue to your chest and create breast mounds. Or actual fat grafting-lipoing one area and injecting it under your breast skin. If you opt for pure grafting know that reabsorption is a big issue and the only PS procedure I know if that’s had any decent success is the BRAVA device. Dr Khouri in Miami is who to consult with for that. Personally I wouldn’t try to graft a whole breast without it. The autologous tissue recon moves the fat to the chest and since it’s done surgically in 1 piece and blood supply is established at the same time it has a much higher success rate. I traveled to NOLA for mine (DIEP) and would do it again in a heartbeat.

www.breastcenter.com

https://www.miamibreastcenter.com/

SpecialK

bpxdomino - here is a thread to read where people reconstructed using fat grafting without a flap procedure, there are BRAVA users on this thread also:

https://community.breastcancer.org/forum/44/topics/788885?page=1

You might want to PM the member dancetrancer - she has recon using fat only and has been generous with assistance and advice.

BPXDomino

Ok thank you for pointing me in this direction!