Questions re: fat grafting

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LoveandLightinLA
LoveandLightinLA Member Posts: 80
edited June 2017 in Breast Reconstruction

Hi ladies,

I've been reading different threads on here re: fat grafting and have learned so much from you all. Thank you for sharing your experiences and your wisdom!

I will be having fat grafting this Tuesday 5/23, and I have a few questions:

1. Will I have drains after fat grafting? Several women mentioned drains in other FG threads. My surgeon said he will probably need about 50 - 60ccs to smooth some minor rippling I have near the cleavage area. He did mention that it takes about 500 cc of fat to process into 50cc to inject into the grafting site. If I will have drains, how many would I have? My surgeon is planning on using the flank area to harvest the fat.

2. My surgeon said I did not need any compression afterwards, but on all the threads I've read, almost all women use some sort of compression for pain relief. I will be purchasing a Spanx high waist panty, and also an abdominal binder. Which do you think is best? I couldn't find a Spanx panty with a snap crotch, so hoping the panty won't be too uncomfortable to pull up and down. Should I just follow my surgeon's instructions or wear compression? Not sure what to do, I just want to avoid pain as much as possible.

3. How bulky are the dressings over the entry points and where the fat is harvested? The weather here in California is getting pretty hot, could I get away with wearing a loose maxi dress to wear home after surgery? I figured it's probably the most comfortable outfit I could wear that wouldn't constrict my waist area in any way, but not sure if it will adequately cover any dressings in the breast area. I heard other women say they wear yoga pants home, but those sound tight around the waist area. Any thoughts?

4. Will I need to take antibiotics after? Not looking forward to that...had bad reactions to 2 different antibiotics after my mx.

5. I developed a rash all over my torso after my mx, I think it was an allergic reaction to the pre-op antiseptic solution they used. Is there anyway to avoid this again? I would love to prevent this from happening, are there different anti-septic solutions they can use?

6. How many days before you were able to be out and about? My daughter has a music concert at school 3 days after my surgery. Is there any chance I would be able to make it? Or is that too soon?

7. The fat grafting is primarily to smooth out rippling near my cleavage area, but do you think it is possible to inject fat near the nipple area as well? I had a nipple delay procedure done, and they removed tissue underneath my nipple, so it's a bit flat compared to my other breast. Has anyone had FG done in the nipple area?

8. Is there any other advice you would love to share re: fat grafting? I'd love to hear from any of you that have gone through this before. Thank you so much!!! :)

Comments

  • NotVeryBrave
    NotVeryBrave Member Posts: 1,287
    edited May 2017

    I can't speak to anything about fat grafting since I'm new to all the PS stuff. However - there are most definitely other options for pre-op antiseptics. You would probably need to check with the original hospital about what they typically use - I'm not positive if it would be listed in your operative report or not. Most places use Chlorohexadine. Most will substitute Betadine for allergic reactions. I would check!


  • LoveandLightinLA
    LoveandLightinLA Member Posts: 80
    edited May 2017

    Thank you NotVeryBrave! I will definitely ask when I get to the hospital tomorrow. I hope you are healing and recovering well! :)

  • SpecialK
    SpecialK Member Posts: 16,486
    edited May 2017

    Love and light - I have had a bunch of fat grafting, I will attempt to answer your questions.

    1. I have not seen drains for FG alone, drains would be used when FG is done along with a complex exchange or revision.

    2. I would look for a snap crotch panty - check Amazon and opt for expedited shipping - doesn't have to be Spanx brand. Rolling the panty down to use the bathroom will hurt. I don't think any abdominal binder will compress the correct area. I would recommend that you wear compression - it helps with discomfort and helps prevent firmness/lumps that happen when the cannula tunnels fill with fluid.

    3. My dressings were essentially bandaids or gauze under paper tape, not at all bulky.

    4. Ask your PS about the antibiotic. Since you have implants you are at higher risk for an infection that threatens the foreign body. You may be able to take a less intense med since this is not a very invasive procedure.

    5. Ask about whether they can use Betadine, I have this same issue and it works for me.

    6. No way to tell about your daughter's concert - I could drive after several of my FG procedures by day 3. Depends on a number of factors.

    7. Entirely possible that they can put some fat under the nipple for you, your PS should mark you in pre-op and you can discuss then.

    8. Eat increased protein, don't compress the graft area, treat it gently. Arnica cream or gel (OTC) helps with bruising at the donor site. My PS restricts exercise for at least two weeks, maybe longer depending on the circumstances. The compression is not comfy, but it really helps. It takes up to 6 months to see how much of the fat will stay, mine has done very well Good luck!

    Edited to add Amazon link for shapewear:

    https://www.amazon.com/Maidenform-Flexees-Womens-Shapewear-Romper/dp/B0055X1NOE/ref=pd_sim_193_38?_encoding=UTF8&pd_rd_i=B0055X1NDA&pd_rd_r=NGZC095A0VKVY9Q3P5KD&pd_rd_w=397yD&pd_rd_wg=fvN2j&refRID=NGZC095A0VKVY9Q3P5KD&th=1&psc=1

  • LoveandLightinLA
    LoveandLightinLA Member Posts: 80
    edited May 2017

    Special K - Thank you so much!!! I am so grateful to you for all the wonderful advice and information. You are amazing!!! :)

    And thank you for the amazon link, I ordered that shape wear immediately.

    I feel so much better going into surgery today. :)


  • SpecialK
    SpecialK Member Posts: 16,486
    edited May 2017

    love and light - I'm so very glad the info was helpful. If you have questions subsequent to your procedure please ask! Hope things are going well

  • LoveandLightinLA
    LoveandLightinLA Member Posts: 80
    edited May 2017

    Thank you Special K! My surgery went well, I'm home recovering and feeling pretty good!

    I did have 2 post-op questions for you:

    1. My discharge instructions said to wear a bra at all times. I thought the breast area was not supposed to be compressed at all? Do you think it is ok to go braless? At least at home? After my mx and direct implant reconstruction, I was told not to wear a bra at all. How important do you think it is to wear a bra?

    2. Can I put an ice pack on the harvested areas that are sore and tender?

    I look forward to hearing from you!

  • SpecialK
    SpecialK Member Posts: 16,486
    edited May 2017

    loveandlight - sorry I missed your questions until now - I should have checked sooner! Is your bra pressing on any of the grafted areas? My surgeon had me wear a surgical bra but it did not squeeze any of the grafted areas, just kept the bandages supported. As far as ice, most docs don't recommend it as it has not been shown to improve swelling, and can be dangerous because the skin may be numb and it could cause issuesif ice stays on too long. Did you receive any instructions from your PS about ice?

  • LoveandLightinLA
    LoveandLightinLA Member Posts: 80
    edited May 2017

    Hi Special K - no worries at all! Luckily my recovery has been pretty easy, so I never ended up using any ice packs. And I was able to find a really comfortable soft sports bra that doesn't press on the grafted area.

    It's been a week since my fat grafting procedure, I'm still a little sore but definitely manageable. My surgeon only took about 50cc to smooth out my cleavage area where there was rippling. It looks smoother, but I can already see some rippling 1 week out. :(

    I was really hoping I wouldn't have to do any more fat grafting procedures... the rippling isn't bad...but I really wanted my cleavage area to look perfectly smooth and soft. Would you recommend doing another fat grafting procedure in the future? I wish my surgeon had used more fat the first time around, but I read that they do it that way on purpose.

    I had asked my surgeon if he could possibly fill in the area underneath my nipple and a hollow area above my implant near my armpit. I think he just focused on the cleavage area for this round. How many fg procedures do you think I would need to fill out the areas I mentioned?

    I'm torn between accepting what I have right now, and stopping with the surgeries, or continuing with fg until everything looks perfect. What do you think?

    Sorry for all the questions Special K! I look forward to hearing from you whenever you have time. No rush! Hope you are well!!! :)

  • SpecialK
    SpecialK Member Posts: 16,486
    edited May 2017

    love - I shortened your name, lol! No problem on the questions, ask me anything, any time - you can continue with FG but you have to know you may continue to reabsorb the fat and it may not help - I would wait a beat to see what happens with this round before deciding on doing more. I have had a bunch of FG done for differing reasons, but it doesn't always prevent rippling, particularly in areas with thinner skin or bony structure like the cleavage area. I had the initial FG done - really my only one for aesthetics, in which quite a large amount of fat was grafted above my implants and got a great result - I have obedient fat, lol! I tend to not reabsorb, but I know that I am lucky in that regard. The rest of my FG was done for skin integrity, much like for ladies who have had rads, even though I did nopt - unfortunately, my skin doesn't heal well so the FG really helped. It would be worth talking to your PS about what is the experience with number of grafts needed and whether the nip area can be improved. Thanks for asking about me - I am having a vascular procedure tomorrow on my left leg, I have two incompetent veins that will be re-directed by use of an endovenous laser - a little nervous, but hoping it goes smoothly. I will either not be looking at BCO because my leg hurts, or I will be looking at BCO a lot because I can't move - not sure which yet, lol!

  • LoveandLightinLA
    LoveandLightinLA Member Posts: 80
    edited June 2017

    Special K - Thank you so much! I will take your advice and wait for a while before making any further decisions about more fg. I hope your procedure went well! Wishing you a very easy and speedy recovery and much healing! Take good care of yourself, hope you can move your leg again soon. Sending you {{{ hugs }}}. :)

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