Fat grafting
Fat grafting is a procedure that transfers fat from one part of the body to another. In breast surgery, it is used to help improve the breast contour after previous surgery, usually after breast cancer. It can also be used to reverse some of the changes associated with radiation therapy.
Fat is usually taken from the tummy or thighs. The fat cells are isolated and reinjected where needed in the breast area. It is usually performed as a day surgery and can often be combined with other procedures such as implant or exchange or symmetrisation surgery.
Key points
- Transfers fat to improve shape or feel of breast
- Usually a day procedure
- Wear tight fitting underwear/shorts for 2 weeks
- May need more than one procedure
Alternatives
Fat grafting is usually used to improve the look or feel of your breast(s) after previous surgery, so it’s okay not to have anything done unless you want it. If you are unhappy with your reconstruction you can choose to go flat instead (and use an external prosthesis) or discuss alternative options for reconstruction (such as tummy or back flaps).
Potential problems
- Bleeding, including a pocket of blood under the skin (haematoma) (5%)
- Wound infection (<5%)
- Change to the shape of your breast
- Need for a second surgery (usually to ensure all cancer cells are removed) (15%)
- Breast cancer recurrence (1% per year)
- Risk of anaesthesia (low)
Associated treatment
Fat grafting can be combined with other procedures such as implant exchange or symmetrisation surgery (an operation on your other breast to create a better match).
It is normal for some of the grafted fat to get reabsorbed over time. Many patients need more than one procedure to achieve the desired result. It is also important to have realistic expectations of what can be achieved in your unique circumstances.
Fat grafting can cause changes that are detected on scans in future, so occasionally people need further imaging or a biopsy to make sure there is nothing to worry about.
Although fat grafting seems to be completely safe, the signals given out by transplanted cells might theoretically stimulate any dormant cancer cells. Studies have not identified an increased risk after fat grafting, and there is always a small risk of breast cancer recurrence, with or without it. If you did get a recurrence in future it would be impossible to tell whether fat grafting was a factor or not.
On the day of surgery
You will need to fast for 6 hours before surgery. You can take any medications as normal and continue to drink water until 2 hours before surgery.
You should shower and wash well in the morning. Bring something to do as there will be a lot of waiting.
When you arrive you will be checked in by the nurses and change into a gown and stockings ready for the operation.
In the holding bay
You will see your surgeon and anaesthetist, have a drip put in and have the operative site marked. You might also be given premedication.
In recovery
After surgery you will go to recovery. You will be watched closely until you are alert and well enough to return to the ward. You might be given medication for any sickness or pain.
After surgery
Swelling or bruising is common and usually settles on its own. Often there is some mild redness around the graft site for a coupe of weeks.
Your dressings will be splash resistant but try not to soak them. Pat them dry after a shower. You can remove them if they start to peel off but if they remain neat and tidy keep them on for at least 5 days and up to 2 weeks
Wear compressive shorts or underwear night and day for 2 weeks.
Pain and discomfort can usually be managed with simple painkiller tablets.
Eat healthily and try to exercise a little every day. You might find your movement restricted for a while. The exercises given to you by your breast care nurse will help to minimise stiffness.
If you have any concerns call the team - we would rather know about it and you are never wasting our time! We can always arrange for you to come to the clinic if needed and if you are unwell out of hours you can always attend the emergency department.
Driving
You need to be able to concentrate properly and perform an emergency stop without any distracting pain. You will probably need to avoid driving for 1-2 weeks, but check with your insurance company.
Work
Getting back to work can be necessary or helpful for many women, but you will probably need to wait at least until you get your results and can plan any further surgery or treatment.
EDI: mybreast