Softer silicon implant and lipomodelling/fat transfer?

I have Mentor High Profile implants, alloderm, and have had fat grafting.  I am VERY pleased with my results!  The fat grafting has done a lot to help with the radiation damage - tightness has gone away and implant has dropped nicely to come close to matching no rads side.  Fat grafting has softened the edges and made them feel warmer to the touch.  They are very movable in bras and make nice cleavage .  I am very glad I had this option; a flap procedure was not for me.  I think this is a good option for you to explore.

My alloderm was put in at time of initial surgery for TE.  I have had one fat transfer.  I will probably have one more in April (have a bit of a ledge/shelf on top of the one implant yet).  Fat transfer is not a fun procedure, but I will be glad to do it a second time as the results have been so good for me.  This should be my last.  

Hi,

I have some questions for you all - my PS talked about doing lipo or fat grafting to create more cleavage and projection which I had asked about. I'd like to be more filled out vs. blown up like a balloon, if you know what I mean. Is fat grafting and lipo the same thing? I know they've used lipo for years for regular plastic surgery. I wonder how long it's been used for cancer survivors. Is it painful? Is it safe? Are there any side effects and does it last? 

Thank you!

I have had two fat graphs to date and my experience has been extremely positive.  I have had an increase and warm sensation.  My plastic surgeon is using fat grafting to actually rebuild breast tissue on and around the implant. My ultimate goal is to have explant of implants and have only fat grafting as my breast tissue.  I was not a candidate for any kind of "flap" procedure nor could I entertain the 'brava' method.  I was really worried I would never look the same.  I suffered from post mastectomy pain syndrome and also had extremely thin skin left to work with.  

Fat grafting has actually resolved my pain syndrome and has built breast tissue overtop of the implant so it is not thin or cold anymore.  My PS expanded my tight scar areas and my breast tissue by using saline infused to these areas to expand the tissue out.  I have actual soft, warm breast tissue on all areas of my breast that were grafted and a very small implant in place at the moment. The recovery to the breast after fat grafting was very easy.  The recovery to the liposuctioned areas is not so easy.  Compression garments are key to successful recovery and results of the areas that are liposuctioned.  I wore a degree of compression garments for four weeks to 12 weeks depending on the area liposuctioned.  For compression garments, I used either tightfitting athletic wear or a "Spanx-type" garment.  I can't say enough about my personal own experience with fat grafting to the breast. I never thought that I would be able to feel that area of my chest again. Nor did I ever think I would be comfortable with the way I looked. One of the additional benefits of fat grafting is the area that is liposuctioned is contoured to really improve the way that part of the body Looks.  I didn't expect to see such a drastic difference and the contour with only a small amount of fat removed.  

My recovery for fat grafting wasn't as bad as the mastectomy recovery but it's definitely a different type of recovery for the area where the fat is removed from.  I say it's a walk in the park compared to a BMX.  The skin will feel loose for many weeks, or even may feel "ripped", and you must wear some type of compression garment.  This can become a bit cumbersome because you have to always have the compression garment on under whatever you are wearing.  In warmer weather, compression garments underneath regular clothing can become very warm very quickly and you'll need more than one or two.  For the first couple days, the area where the fat has been removed will have residual amounts of lidocaine solution in it so the pain from those areas is not as bad.  After that, the pain is similar to when you either overwork a muscle during exercise or have a sunburn underneath your skin.  I didn't have hardly any breast pain after the fat grafting nor did I have those awful muscle spasms like after implant placement.  The only areas of discomfort was where the fat was removed.  That being said, I can't say enough about the positive results that I have received from doing the grafting.  

For donor areas, I used the bottom of my thighs for my first grafting. For the second grafting I used my back fat. I have been a lifelong athlete and getting rid of fat on my back was almost impossible. I used this fat as a donor area and I no longer have back rolls.  Recovery to the thigh area took much longer than the back area.  For me, the thigh area felt like I had done a really hard work out. It felt more like sore muscles than it did like a pulled or ripped skin feeling. I'm going to say for the thigh area I needed to wear some type of compression garment for 12 weeks. I used leggings as my compression garment. For the back donor area, (they removed some fat from the upper part of my back and a little bit from the upper-hip/waist area).  

My recovery for the back and upper hip waist area was much shorter then the recovery from the thigh area. Recovery, for me, for the back and waist area, was only about 4 to 6 weeks. I wasn't in pain in those areas but you do have a sense of a feeling of loose skin or maybe more appropriately, ripped skin.  Wearing something snug on these areas (like a really snugly fitted cami or wrapping ace bandages around you) helps to alleviate that feeling but jumping or running (or anything that is going to jar your body) is going to feel narly in those areas. Keeping something snug on those areas is the key to staying comfortable. I also wasn't able to work out after fat grafting.  This was probably one of the hardest things for me to do. You're not allowed to work out for at least eight weeks. You can walk but you can't really get that intense cardio workout nor can you sling around the weights.  You want to be really careful with not working out your upper body at all because the fat needs time to "take". 

Once the grafting areas healed on me, the results looked so incredibly good that I was very happy that I was able do it.  Having a normal feeling breast, or more normal feeling breast, was the biggest reward of all.   My ultimate goal is to have fat only but for now I will be incorporating fat with implants. After two fat graphs I have almost full sensation in my left breast. And my right breast I have about 65 percent.  When the sensation returns to the breast area it can be quite an emotional experience.  I cried when I first realized I could feel one side.  After about 4 months, my legs results were evident and none of my pants now fit.  After 2 months, my back and waist results are evident.  I went from a 42" band bra to a 38" band bra.  My waist is drastically smaller.   I thought I had a pretty decent waist to begin with but I am definitely waay smaller in that area now. I have to wear a smaller shirt size because my back and waist are so different than before.  I don't really understand why there is such a difference than before as my PS only takes out about 100cc for each breast -but I had never had any sort if body contouring before so I have nothing to gauge my experience on.   I hope this has been helpful. Please if you have any questions, feel free to ask. I don't have the most experience posting to message boards, but am trying to navigate my way around.  My sincerest wishes for the best of luck.

i thought it was a great post. maybe leave it here plus post a copy on the other thread.

hi,

Butterfly, I just came across your post about implants and fat grafting. I have been planing my reconstruction which initially suppose to be a diep flap. However, recently I was told by a couple of dr that I'm not a candidate for any type of a flap. It seems like my only option (I live in Canada) would be TE and then implants with some fat grafting.  Did anyone have delayed (after tx and rads), TE /implants placed on radiated side without using any flap or back muscle? If yes, please share your experience.

I'm also confused as to when is the fat grafting done in cases like that? Before the implant is placed on radiated side or after? I read that some women get fat grafting done to rebuild the radiated skin before placing TE. 

peacestrength, are you from Canada? It seems like there are more reconstruction options accepted by insurance in United States then here.

Butterfly, I know this is years later, but would you be willing to share pics or pm me pics? There are very few women who've had this done and it's hard to find photos. Thanks so much for sharing your story!