Fat Grafting After Lumpectomy

I am in a unique position - did not have lumpectomy or radiation, but did have issues with skin necrosis that have left me with thin and damaged non-healing skin on the left side, complications similar to radiated skin.  I had issues almost immediately after skin and nipple sparing BMX in '10 that caused several skin excision surgeries and eventually the loss of the left expander.  My skin did heal once the TE was out, and I went on to have it replaced after chemo and expanded and exchanged without complications.  The reason I am posting here is that during an allograft repair in the spring of '14 that same area of skin tore during surgery - I had another surgical try in April to excise and heal, but lost the left implant in May.  My PS has done one fat graft to the empty wrinkled skin on the left side - much as fat is grafted to radiated skin prior to reconstruction or exchange surgery.  The thought is that it helps increase thickness and vascularity to the area prior to stretching.  This is a fairly new approach and is used more widely in Europe, but it is worth considering if your radiated skin is causing issues.  I also had fat grafting a year after the original exchange to fill divots above the implants and to soften the step-off - it did wonders to soften and fill in - I would imagine that this could also work for lumpectomy, but the same risks exist - fat necrosis, reabsorption of the fat, lipoma, etc. The other thing I wanted to note is that unfortunately insurance is not very cooperative on this matter - the federal legislation available to help provide symmetry after mastectomy does not apply to lumpectomy so many insurance companies will not cover fat grafting after lumpectomy.  Check with your insurance company to see if they cover fat grafting - it would be worth having your PS speak with them to fully explain why this is necessary, and also provide photos.  In some cases people actually have to resort to more drastic surgery - mastectomy - to get insurance to cover symmetry surgery.

Hi. Were your breast reduction and the fat grafting to the other breast two separate surgeries? Why were they not done at the same time? Thank you. Are you happy with the results?

Hi all, read all the post here and thought I would share my experience.  I was diagnosed in March of 2011, and finished radiation in November of 2011. Continued on Herceptin until July of 2012.  In September of 2012 after fighting with my Health Care provider about fat grafting, they finally made 1 of their plastic surgeons do this for me.  I should say that my Husband is a CMD, so he makes all the treatment plans for radiation patients, so new this physician well.  After I had the physician on board, he did a bunch of research and was excited about this.  I had a very high tumor just about an inch under where my port was on my right breast.  This creative a ver big "divot" in that area, it literally looked "scooped out".  He took fat from my abdomen area and then spun that down and implanted the stem cells and concentrated fat into that hole, he also put some under the spot where they dug out near my nipple.  (they removed more than was originally thought once they got in there). After the first surgery I saw great improvement, I knew going in that for the volume only portion of the fat grafting only about 16% stays long term, and that I would need more than 1 procedure to complete what I wanted.  Since then I've done 2 more surgeries, (fat taken from abdomen, and thigh's) and I'm going in again this September.  The recommendation is to wait 6 months to let things "settle", unfortunately my surgeon left after my 2nd surgery and I saw the only surgeon available at the time, and he didn't do what he should have which is why I'm having this done once more.  I am going to have him release some of the scar tissue near my nipple and just add more volume since we are in there any ways.  I've had 4-5 mammograms since starting this procedure, and because of the location of the original tumor they always have trouble doing the mammo on me, but all my mammo's have been good, and I usually view them with the technician, (I work at this particular hospital, so maybe get a little more service than other's may)  I am nothing but happy with my results.  At this time I've chosen not to do the lift on my "good" breast, but may later down the road.  I really wanted to find someone to give me implants, but I checked all over North Dakota and Minnesota, and every surgeon said it was irresponsible to do so as the problem rate is so high.  I have read online of people who have had them with radiation to the breast, but I've not seen any "reputable" places like Mayo or anywhere doing that....  So far I'm happy with my result, and no issues.  The stem cells helped regenerate the feeling where my lumpectomy was, its not the same as on the other breast, but I have pretty good feeling there, and my nipple has complete and normal feeling.  I could probably have stopped after the first surgery, and very few people can tell the even slight difference in size on me, so I would encourage everyone to do something to make yourself feel whole again, whether its fat grafting, or reduction of the other breast, etc.  I should mention that my Mother had the same tumor in the same spot in 1995 and chose to make her "good" boob smaller with surgery.  She is happy as well.... We had the BRCA testing done, and I was negative which was a huge relief for my Mom, and for me, hoping my daughter won't suffer the same fate.... Thankfully she is not growing up where I did, and feel that my breast cancer was environmental.  Can't prove it, but too many girls I went to school with had BC in their early 30's that stayed in that area, so just my theory....  Good luck to all the ladies.  I should also mention that truthfully, the donor site hurts worse than the actual surgical sites.... But compression garments and wear them even to bed for six weeks.  It will make a big difference for a nice smooth tummy....