Fat Grafting After Breast Reconstruction

What is fat grafting?

Fat grafting, also called fat transfer, moves fat from an area of excess to an area that needs volume, contour, or improved tissue quality. It is used in both implant-based and natural tissue reconstruction as part of secondary revision surgery.

It offers a dual benefit: removing unwanted fat from areas like the abdomen, hips, or thighs while improving the reconstructed breast. The transferred fat re-establishes a blood supply from surrounding tissue and becomes a permanent part of the body.

What can fat grafting address?

Contour irregularities, implant rippling and visible implant borders, insufficient volume, and the overall quality and texture of the overlying skin. It also plays a supporting role in animation deformity correction and flap revision, where it camouflages edges and blends transitions.

How is fat grafting performed?

In the operating room, fat is harvested by liposuction from donor areas, most commonly the abdomen, hips, or inner thighs. It is processed and carefully injected into the breast in small, layered quantities to improve shape and contour. The procedure is relatively quick with minimal downtime compared to more complex reconstructive surgery, and it can be performed alongside implant exchange, nipple reconstruction, or other revision procedures, or as a standalone operation.

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How many sessions will I need?

Approximately 60% of transferred fat remains viable at six months, so multiple sessions are often needed for the optimal result. The number depends on the volume required, the quality of available donor fat, and whether radiation has affected the recipient tissue. Radiated tissue has reduced blood supply, which limits how well transferred fat integrates.

Can fat grafting fix contour problems after lumpectomy?

Sometimes. Fat can fill divots and hollows after lumpectomy and radiation, but radiation-related scarring at the site can significantly reduce graft survival. For these cases we generally prefer local flap techniques such as the ICAP, TDAP, or IMAP flaps which bring healthy, well-vascularized tissue directly to the affected area.

Is fat grafting safe after breast cancer?

There is no clinical evidence that fat grafting affects breast cancer recurrence in women who have undergone mastectomy. Studies specifically examining grafting into lumpectomy cavities are more limited, and we are glad to walk through the current evidence with you at consultation. Honest answers about evidence, including its limits, are part of the plan.

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