Fat grafting after lumpectomy/radiation?

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lane4
lane4 Member Posts: 175
edited September 2014 in Breast Reconstruction

I am hoping to hear from women who have had fat grafting to correct lumpectomy defects or asymmetry in a radiated breast. I've been told that about 50% of the grafted fat will not thrive, but I can't seem to find much about what happens to that fat. Does this always result in fat necrosis that surgeons and radiologists feel they have to biopsy? Or can they tell the difference between fat necrosis and recurrence? Does the necrotic fat cause infections, or does the body eventually reabsorb it? I have read about all I can find on the topic, but would really like to hear from people who have really done this. I also would like to know if it's common to have to repeat the fat grafting and if the results can be disappointing. Thank you!

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  • Louisa2
    Louisa2 Member Posts: 49
    edited July 2011

    I've got necrosis after a TUG reconstruction.  I too am considering microfat grafting to address this.  My plastic surgeon said that they would do some liposuction on the necrosis first, to remove some of it and kind of "break it up."  At least that's the impression I got.  It didn't sound at all like they would suck out the entire gob, which is maybe the volume of a  ping pong ball, but it's hard to tell because it's shaped irregularly.  My pc said that it generally requires a series of treatments--they can't graft a big chunk of fat because it wouldn't have a blood supply.  So they do it in little bits, and then the existing blood supply nearby can expand through the little bits.  But if the bit is too big, it will die before the blood supply develops.   

    I am not at all crazy about the idea of living with this hard lump.  It's at times uncomfortable and doesn't move naturally like the rest of the breast does.  But I guess I'd rather keep it than wind up with failed fat grafts and needing to use a prosthesis to fill in a sunken spot.  Nothing is a sure deal, it seems.  The reason I did TUG in the first place was to avoid needing to use a prosthesis.

    Anyone who has personal experience with microfat grafting--I'd love to hear about it.

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  • Anonymous
    Anonymous Member Posts: 1,376
    edited July 2011

    I recently had micro fat grafting in my revision surgery and I wanted to make you aware that there are different methods of FG but they're all called the same thing.  I didn't have mine after lumpectomy but to correct some issues I was having with my implants after BMX.  The majority of PS who do fat grafting inject globs of fat into the desired area.  Unfortunately, with this technique about 50% is reabsorbed and there is a higher risk of the fat calcifying into hard lumps which, obviously, can be pretty scary to someone who has been previously DX with BC.  The other method, developed by Dr. Roger Khouri at the Miami Breast Center, first develops a space for the fat to go by using something called the Brava system ahead of time.  This space, called scaffolding by Dr. K, is then used to inject the fat drop by drop.  About 85-90% of the fat is retained and there a lot less chance the fat will calcify.  Dr. K has been teaching his method to other surgeons all over the world.  He currently just performs this in Miami.  You can find out more info at miamibreastcenter.com.  During my recon he removed my implants, replaced them with smaller ones and then did extensive fat grafting over the top.  There is also a thread of here about micro fat grafting titled (appropriately enough)- Has anyone had micro fat grafting?  You can get more info from other women who have had it done and ask about it in regards to lumpectomy.

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  • Meece
    Meece Member Posts: 19,483
    edited November 2011

    My fat grafting was done by using a pocket under the area to be filled and "laying" lines of the fat side by side then crossing lines over.  It was two years ago and at that time I asked my PS about the brava system and he said it was not studied enough as of that time, and that he would not be comfortable traumatizing the radiated breast tisue with the brava vacuum.  I got good results with the method my PS used.

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  • Julz
    Julz Member Posts: 1
    edited September 2014

    I too had a bilateral TUG flap, into it now for 6 weeks.  My radiated breast (back in 2002) is now hard and has shrunk and some dimpling after the reconstruction. :(  My PS wants me to wait until December to correct it with fat grafting, followed by a few more fat grafting procedures in 2015 as it has to be done in small amounts in order for your new blood supply accepts the fat.  Has anyone had a similar experience?  My "Unradiated" breast has taken very well, on the contrary with the "radiated" breast.  I also have limited range of motion with that side...  Doing daily gentle yoga to help...  Thank you in advance for any information you feel comfortable passing on.

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