fat grafting for breast reconstruction after a MX

Thanks for sharing, ual0307. It is really helpful to hear the experiences from others.

I am a big fan of the fat banking (they freeze it) -- I was having a hard time committing to lipo every three months...and ladies it was much harder than I thought.  The recovery was a good 3 weeks (back to work in a week) ...sitting was VERY uncomfortable and I had to walk gently.  It absolutely did take 3 full months for swelling to go down.  And drat....no miracle thin thighs on the other end.   I have 8 little "nicks" that look like they will be invisible before too long.

So the second procedure was a breeze....45 minutes in and out.  Tylenol that night (because I am not very tough)

I don't think there are many doctors that are doing the fat transfer, and I only know of one (in Orlando) doing the banking.

Because I remember how many questions I had and how anxious I was, I'll share.

The first procedure was both the lipo to bank and the first graft to the breast. I went to the plastic surgeon's at 8 am, and I was back at the hotel by 2:30. The procedure itself was about 2.5 hours long. I don't recover well from anesthetic so I was light headed the first day and did not get up much. After 24 hours I took a shower and we went out for food...but they were short trips. I took pain pills the first day. Tylenol the second. By day two was moving around slowly, and carefully. The procedure was Monday, I flew home on Friday. I could have gone back to work by Friday if it was local. I did go back to work Monday.

I started walking on Monday, wearing the compression garment, and according to Drs. order I was back to my normal routine (3miles per day) within 3 weeks. The was little or no pain in the chest.

The second procedure, went in at 8am, back to hotel by 10:30. Still sleepy for the rest of the day, but after 24 hours took a shower and was up and going. A little more pain in chest this time, but twice as much fat went in.

So everything is out patient. no hospital stays at all.

I had a modified radical mx with rads and chemo. No sparing anything. I regained full range of motion with PT after surgery, with PT after rads. Was sore after both fat grafts, it took me sometime to get the stiffness out. Most of the stiffness was caused by the BRAVA not the graft. (I'll talk more about the BRAVA if you are interested) So I don't think I have any range of motion issues from procedures.

I am a B cup (on my best days), but actually plan to use fat graft to augment other side. I think I have earned a C cup and a little cleavage :-)

I took a year after treatment to decide what I wanted to do for recon -- mainly I was too tired to recover yet again. For implants I would have a procedure to graft fat to heal skin from rads, then a surgery for TE, then trips back and forth for "fill". Another surgery for exchange. Wait. Then another surgery for symmetry. It seemed harder and wouldn't take any less time. I did not want another scar, nor did I want to open my incision again...it was just starting to look better.

Since the fat grafts, the color from the RADS has faded...almost gone now. And the scar has improved dramatically. I am optimistic that it may even get better. There is also a small chance that feeling will improve, and no matter how small I am in for it.

I also looked at a latissimus surgery option, but again didn't want the scar, and new it would take multiple procedures.

The down side to the procedure is that because so few drs. do the procedure, my doc is out of network. But he has worked with me to control costs. My doctor is also not local so I have to travel, but that was going to be an issue for me because of where I live.

I started in January, hope to be done before end of year so I don't have to pay another deductible, but there is a reasonable good chance that I may have to.

Let me know if you want to hear about the Brava.

Hi FemaleAthlete

I am not worried about matching....even if you do a bilateral dr. has to make them match. I did everything I could to save every original part. I doubt the touch of a soft caress is the same on any reconstructed breast. I'll risk a little difference for that.

I was not a candidate for nipple or skin sparing. I did not have big enough margins. So all of the tissue, fat, and lining of my chest muscle was removed and I was left with a tight scar, and after radiation very dark ...very "tough" skin. The first two fat grafts have reversed most of this...the color is much better, and the skin moves.

Recovery from the lipo was not terrible. I expected to be up the next day from everything I heard, and I am just saying I wasn't. There was more pain than I expected but I would not compare it at all to the down time after MX, or what I imagine after other reconstruction options. And yes my thighs are much better shaped after lipo. I have always had very heavy thighs and they are better now. But better like I lost 15lbs, not the miracle I was expecting. But the shape is better than ever. I am 5'11" tall, and weigh 170 (155 is a great weight for me). I'll be 50 soon. I think I secretly wanted to look like I was 25 after the lipo. :-)

Waiting a year was my choice. After surgery, chemo and radiation I was exhausted. I was tired of not feeling well. I was tired of doctors. I wanted to be done. I looked into the customized prosthetics and almost convinced myself to not do reconstruction. But about 6 months later I felt better, swelling from chemo resolved, joint pain from chemo resolved. My husband wants to sail around the world one day....and I don't know whether we will do it or not...I do know I could it do it with a prosthetic. Drs. could not find anything high, anything low, nothing to watch....so I made some appointments with half a dozen PS. Found the solution I was willing to do, and then waited for January to try and get it done in a deductible year.

The brava is a pair of domes that you wear over a breast or over the spot where the breast is suppose to be, with a vacuum pump that expands the skin and make an edema mound that they fill with fat later. While the Brava clearly falls in the "what a pain in the butt" category, there was no horror. The worst thing that happen was I gave myself a big brava-sized hickey (pump little too high). I start about 10 days before each procedure at 12 hours per day. My pump (I bought off eBay so I did not have to rent) fits in a pocket. The last three days before procedure I wear it 24hrs a day. I'll wear it out when I need to. Had breakfast with a friend and it wasn't noticed -- or at least they were polite enough to pretend. During the last day I get very annoyed and REALLY tired of it, but it is very doable. After procedures, I wear it at night with a much smaller pump for three weeks....or almost three weeks. It was expensive $900 bucks. Ebay pump was $300.

My PS told me I could be whatever size I wanted to be, he would make the other side match. And while I think that is what I will do, I am waiting to see.

So I have about 12 little scars from lipo, about 1/4 inch. Two you can see in clothes (above my knees); you can see 6 if I am in a swimsuit. They look like bug bites now, but I expect they will not be visible for much longer.

I'll be thinking of you. Take care of yourself.

One last thing, I scheduled myself for a bmx because I was very afraid. In the last two days before surgery I switched to a umx. While I was still afraid, I decided I wouldn't make decisions because of it. There isn't a right or wrong answer.

hey female athlete, we are thinking of you. as you can read  Ihave silicone. and inspite of all their work (ps)on your chest there is some difference in each implant. so often whatever reconstruction you choose there may be some difference from one side to the other.My cousin is currently thinking of the fat transfer boob but you also I believe have enough fat to transfer.

Take care of yourself and let us know how you are.

it's good to hear from you. I'm so sorry to hear about a second surgery. The first time is bad enough.

Decisions are always hard.

Don't worry about recon you've got no time pressure for that.

Rest. Take care. Try and keep worry in check -- it won't change a thing.

Hugs.