Anyone who has had fat-grafting, I have some questions...

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weety
weety Member Posts: 1,163

I am having fat-grafting done in a few weeks from my love handle area and thighs to help rejuvenate the skin over my mastectomy site to help in revascularizing it and helping it to better stretch to start an implant process again. (I lost the previous implant due to infection and am now trying to start over.)

I am looking for women who have had fat-grafting done so I know better what to expect. I know it is pretty much liposuction for medical purposes. I am worried about the cosmetic appearance of the donor areas, though. Do they end up all dented and deformed? Is there a way to minimize this?

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  • VegGal
    VegGal Member Posts: 507
    edited November 2017

    Hi! My grafting from my thighs was done 8 weeks ago. The donor sites look FABULOUS! She somehow made my thighs look defined and I'm a pretty scrawny 55 year old and I look like I've been working out now. I've gotten a lot of compliments.

    I was a bruised mess for a couple of weeks, but it wasn't as painful as I was expecting. I began massaging the donor areas on day 3 so maybe that helped.

    Hope you have great success and the breast skin gets soft and supple. In any case, I think you will be loving your legs!

  • Herculesmulligan
    Herculesmulligan Member Posts: 175
    edited November 2017

    So how much fat do they take from the donor site?

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

    Hercules - generally, your surgeon will only take as much from the donor site as is needed to accomplish correction of the defect - so this varies from patient to patient. If the surgeon removes more than is necessary insurance can deny coverage and deem the surgery "cosmetic" rather than an addition to exchange or a revision

  • Rrobin0200
    Rrobin0200 Member Posts: 433
    edited November 2017

    had my fat grafting surgery a little over a month ago. Other than bruising and swelling that lasted approximately 2 weeks, it's been a walk in the park. No denting, no dimpling.

  • VegGal
    VegGal Member Posts: 507
    edited November 2017

    I don't know how much she took but before surgery she was talking 200 cc's. In my follow up appt she said she "didn't take much" and I didn't press for an exact amount. She did save my abdomen in case I need more grafting later.

  • weety
    weety Member Posts: 1,163
    edited November 2017

    Thank you for all your answers. I don't have much fat to take (which normally is good, but in this case it limits what can be done), but I do have some in my flanks and thighs that he is going to try to use. I was just worried that since there isn't much, the after effects of it being removed would be more noticeable. He is looking for 3 separate places to use to ensure he has enough to rejuvenate my skin, but is only going to use two at this first surgery and then the third at a second one in 6 months.

  • Rrobin0200
    Rrobin0200 Member Posts: 433
    edited November 2017

    Weety, I had the same concerns because I am thin as well. But, my PS took in various areas (a little from abs, a little from thigh, etc.) and I am completely happy with my results.

  • weety
    weety Member Posts: 1,163
    edited November 2017

    Rrobin, I didn't know they could take a little from several different places. I thought I had to have a pretty good pocket of fat for them to be able to access it. Maybe that is because mine isn't being harvested to fill in reconstruction. He is using mine to try to rejuvenate damaged skin left from my last implant failure. He is hoping it helps with improved vascularization and helps fatten the skin up to get ready to stretch again. I think he needs quite a bit to be able to do this, but I really don't know. It was either try this as kind of an experiment to see if he can get it to work, or go through with either DIEP or LAT flap surgery (which I would need an expander & implant with either one anyways.) So I thought I'd at least try the fat grafting since I wouldn't really be losing anything except for time.

  • wallan
    wallan Member Posts: 1,275
    edited November 2017

    Hey there:

    I had fat grafting done to my chest wall after a mastectomy 13 years ago. I then had a tissue expander placed. I have had my final fills and am waiting for the exchange surgery.

    I had two fat grafting surgeries actually. The first time fat was taken from my inner thighs. The second time about 8 weeks later, I had fat taken from my inner thighs, outer thighs and lower abdomen. The surgeon said I have very little fat in all the areas she took fat from. I have no dimpling or indents or anything. Just tiny marks/scars from the liposuction instruments. I do not notice a difference in terms of shape or fat or anything either in my legs or abdomen, and I am not overweight. I didn't even realize dimpling was an issue with fat grafting.

    My surgeries went well. I was bruised and my legs felt like I had a good workout at the gym for a few weeks. Other than that, healing was fast.

    I have had no issues with my tissue expanders either. Even though I had radiation 13 years ago for BC, with the fat grafting, the stretching of the skin went very well. I wonder what the exchange surgery will be like? I hope there are no issues.

    Good luck to you.

    wallan

  • Herculesmulligan
    Herculesmulligan Member Posts: 175
    edited November 2017

    Just wondering.....did any of you share with friends and coworkers that you were having fat grafting? If so did you get lots of offers to donate fat? I thought that was so funny, how many people made that same joke. (And yes I laughed every time).

  • weety
    weety Member Posts: 1,163
    edited November 2017

    Hercules,

    YES!!! I think that is the go-to response! Lol

    I am so relieved to hear of all these success stories. Thank you all for sharing your experiences!


  • wendcarm
    wendcarm Member Posts: 1
    edited November 2017

    Hi Weety! I , myself am having fat grafting done to add to my right breast for fullness. I am also having the implants replaced with better implants to reduce the swelling. I am quite nervous and don’t know what to expect. Did the doctor say that after he does the fat grafting that you most likely won’t have to go back in for more?

  • weety
    weety Member Posts: 1,163
    edited November 2017

    wendcarm,

    I think our situations are different since your doc is only using the fat for fullness. My PS has told me I will need 2-3 surgeries of fat harvesting about 4-5 months apart.


  • buffyjc
    buffyjc Member Posts: 61
    edited November 2017

    I had fat grafting done at the time of my exchange surgery (7 weeks ago yesterday). My PS took 1 liter from my stomach and flanks and he transferred only 70 cc. I have no dents and I don't look deformed. I did have LOTS of bruising and soreness.

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

    I don't suppose that can save that fat in case you need more later, huh?

    My PS told me that probably 70% of his patients get fat grafting after implants and about 30% need a second round.


  • VegGal
    VegGal Member Posts: 507
    edited November 2017

    Ideally the surgeon takes only what is needed, keeping in mind the possible need for another round or more. Mine saved my abdomen just for that reason. Not sure at this point if I'll need it or not. And no, I don't believe fat can be saved for later.

  • mitzi458
    mitzi458 Member Posts: 64
    edited March 2018

    I have not had it done yet and am hoping that my PS will do it, otherwise I will change doctors and find someone who will. I’ve heard that there is a fine line between how much they can take for insurance reasons. If they lipo too much, it’s considered cosmetic and suddenly you might get a nice big bill not covered by insurance. Also I did ask one PS who I had a consult with if he can freeze the fat to use later, and he said that they did not have the proper equipment to do it but hopefully someday he would. I remember reading about a PS somewhere in Florida who does a lot of flaps and he is capable of freezing the fat to use later. That sounds like such a much better idea! I bet before too long many more surgeons will be doingthis.

  • shelabela
    shelabela Member Posts: 584
    edited March 2018

    I had fat grafting done in Jan, my PS took from my waist, back and right under my arms. He took about 275 from each side, then used only 70 to" fill" in around my expanders. He didn't touch my tummy, in July this year he will do the exchange and do more grafting at that time. Said he would take from my thighs and leg area. So far I like the results, and yes i can tell what he did. I took beyond and after pictures. I've showed a could people and they can tell.

    Anyone want to see pictures? I could crop out the "dirty" parts

  • weety
    weety Member Posts: 1,163
    edited March 2018

    Yes, Shelabela! Share pictures! I had my outer thighs used, and I'm kind of disappointed in the results because I have dents where the fat was removed. I think that means he was a little too aggressive, but I don't really think much can be done about it now. In clothes, it is not noticeable, luckily, and I rarely wear shorts or a swimsuit, but I think I will be self conscious now when I do. :( The hip area he took from is not noticeable at all (in terms of dents,) so I wonder if thighs are just trickier to remove without leaving the evidence.


  • VegGal
    VegGal Member Posts: 507
    edited March 2018

    The dents can be fixed! They go in with a tool to loosen the fat around the dents and then roll what looks like a surgical rolling pin over the loosened fat to move it to the dented areas. Once done they cover with a compression dressing and you're good to go! There are YouTube videos that show the procedure.

  • weety
    weety Member Posts: 1,163
    edited March 2018

    Really? You give me hope! lol :)

    Do you think this would be covered under insurance, or do you think this would start becoming part of the "cosmetic" reasons. I also wonder if all places do this or just cosmetic lipo-surgeons. I have an HMO. Not sure if they always do the same procedures and follow the same protocols. I know they do not do cosmetic surgeries at all.

  • VegGal
    VegGal Member Posts: 507
    edited March 2018

    weety, I have no idea about insurance coverage. I have a dent on my right outer thigh and one on my abdomen from the second round of grafting. The first time went splendidly. I will be seeing my PS in May and will see what she says.

    In my case, I am not terribly bothered by my dents, but then again I haven't worn shorts or a swimsuit with them yet. Let us know what you learn.

  • JaneSheridan
    JaneSheridan Member Posts: 9
    edited March 2018

    hi I’m not sure if this thread is still active but to the OP how did it go? I’m doing this in a week and want to get back to work fast.

    Also to the woman who had fat taken from arms - is that common? I’d love to harvest fat from my arms but PS is reluctant due to lymphadeama (sp) risk... TI

  • aquilegia
    aquilegia Member Posts: 83
    edited March 2018

    weety - I had fat-grafting in Dec. 2017 to fill in divots left after DIEP and to plump up the DIEP breast so it was closer in size to my other one. The fat was taken from the "spare tire" area at my waist and from inner thighs. What surprised me was how painful the waist area was for months afterward. I had to pad my hips and waist with surgical pads for months, and it's still sensitive to pressure from clothing.

    The donor areas at my waist still swell up by the end of the day. I didn't get a compression garment (just bike shorts and compression undies) and wasn't real faithful at keeping the abdominal binder on, so the fact that I'm still getting swelling may be partly my fault. The PS didn't touch the inner thigh fat higher up near my pubis, so my thighs bulge slightly above the donor area. In fact, I got flagged at an airport by the TSA X-ray machine for suspicious bulges at both my thighs and waist and had to get patted down! I sure hope that doesn't last indefinitely, as I travel quite a bit for work.

    Whether your PS will fix bulges probably depends what kind of insurance you have and where you get it done. I have Kaiser HMO, and although they are great at keeping you alive, they don't seem real concerned with getting perfect cosmetic results.

    JaneSheridan - I don't know if I could have gone back to work a few days after fat grafting. I scheduled it right before a 1-week Xmas break at work, and was pretty sore most of that time. But I never needed narcotic pain-killers, and getting in and out of cars was no problem although very uncomfortable.


  • weety
    weety Member Posts: 1,163
    edited March 2018

    Hi, aquilegia, I have Kaiser, too. That's why I was worried about any revisions being covered. They do not do anything that is not necessary. I'm in Southern California. Where are you?I'm supposed to go in for the second fat grafting in 2 weeks (this time inner thighs) but now I'm worried he won't get the pocket of fat that is up closest to my pubis like your doctor didn't! Maybe I will specifically ask him about it at my pre-op appointment.

    As for the pain, yes, I had lots of pain with my hips. My procedure was in Nov. 2017 and still have a lot of sensitivity there. The thighs had very little pain, but the hips kept me from doing much for the first 1-2 weeks. I had 3 weeks total off and I don't think I would have been very comfortable going back to work before that. It probably depends on what type of work you do--I'm a kindergarten teacher, so I'm up and down off the floor etc. so it would have affected me a lot.


  • aquilegia
    aquilegia Member Posts: 83
    edited March 2018

    I'm in the Bay Area - Santa Clara Kaiser. They have a breast cancer center and the PS are supposedly also cosmetic surgeons, but attention to detail doesn't seem to be their strong point. That said, I'm OK with how it looks. My PS did offer to do a second round of fat grafting if I want, as most of the divot fat didn't last, but I will have to think long and hard whether I want to go through it again.

  • EZsofar
    EZsofar Member Posts: 9
    edited March 2018

    Does anyone have a recommendation for undergarments after fat grafting? Does Spanx work best?

  • CasinoGirl
    CasinoGirl Member Posts: 673
    edited March 2018

    Hello! Anyone have experience with fat grafting after radiation? Three weeks ago, I had round 2 of fat grafting to breast after lumpectomy. My lumpectomy and treatment was in 2004, so it's been a while :-) The reason it took so long for reconstruction is I couldn't find a reputable PS willing to work with my radiated tissue.

    I finally found a reputable PS, and the results after round 1 of fat graft (done in Sept 2017) were amazing! I had a significant divot in breast after the lumpectomy, and the divot had gotten much worse over the last couple of years, (I was a C cup and an A cup) but after round 1 of graft, "gnarly girl" was full and looking good!

    After round 2 of graft (3 weeks ago), not so impressed. The divot had started to reform as my body reabsorbed some of the grafted fat from round 1 and also had some fat necrosis. PS says the reason round 2 wasn't so successful is due to all the scar tissue from the old lumpectomy, but what doesn't make sense is how he was able to get the fullness first time around if the old scar tissue is the reason for less fullness in round 2.

    Just curious if any of you who've had fat graft had it after radiation? I'll probably have round 3 fat graft sometime this summer.

    Thanks!!

  • smwusaf
    smwusaf Member Posts: 129
    edited March 2018

    casinogirl, I am having that done in sept. same situation, I need to fill out the side with the lumpectomy. Plus I'll be having a lift done on the other side to make them more even. I'll be watching this thread to see other results as well. This is helpful.

    My PS told me to get a really good pair of spanx, cut out the crotch so I could do my business :) and clean up but to keep them on for 2 weeks and that will help with any potential dimpling, lumpiness, etc. She will be doing my fat grafting from my back love handles. She doesn't like to use the tummy unless it's a full reconstruction.

  • wallan
    wallan Member Posts: 1,275
    edited March 2018

    Hey: I had fat grafted to my radiated skin. I had mastectomy though in 2004 with radiation.

    I started reconstruction last May. The PS first did fat grafting to plump up the skin on the radiated side before tissue expander and implants. I had two rounds of fat grafting from my inner and outer thighs and abdomen. The implants were put in 8 weeks ago, and so far everything looks great.

    I really don't know if the fat was resorbed or not. But, I did have a smaller implant inserted on the fat grafted side than on the other side. ( I had another mastectomy last March so this prompted the reconstruction). The surgeon said it was because of the fat grafting padding. To look even I didn't need the same size implants on both sides.

    wallan

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