Fat Grafting After Breast Reconstruction
Fat grafting, also called fat transfer, is a surgical technique that moves fat from an area of excess on the body to an area that needs volume, contour, or improved tissue quality. It is commonly used in both implant-based and autologous breast reconstruction as part of secondary revision surgery.
Fat grafting offers a unique dual benefit: removing unwanted fat from areas like the abdomen, hips, or thighs while simultaneously improving the appearance of the reconstructed breast. The transferred fat re-establishes a blood supply from the surrounding tissue and becomes a permanent part of the body. Fat cannot be donated by a family member — it must come from the patient.
What can fat grafting address after breast reconstruction?
Fat grafting is a versatile tool that can improve a range of concerns, including:
- contour irregularities
- implant rippling
- insufficient breast volume
- visible implant borders
- the overall quality and texture of the overlying skin.
How is fat grafting performed?
In the operating room, fat is harvested using liposuction from donor areas — most commonly the abdomen, hips, or inner thighs. It is then processed and carefully injected back 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 surgeries.
When during reconstruction can fat grafting be performed?
Fat grafting is flexible and can be incorporated at multiple stages, including alongside implant exchange, nipple reconstruction, or other secondary revision procedures. It can also be performed as a standalone procedure to address a specific concern.
How many fat grafting sessions will I need?
Approximately 60% of transferred fat remains viable at six months. Because of this, multiple sessions are often needed to achieve the optimal result. The number of sessions depends on the volume needed, the quality of available donor fat, and whether radiation therapy has affected the recipient tissue.
What factors affect fat graft survival?
Fat graft survival is influenced by the quality and quantity of fat transferred, the injection technique used, and whether the recipient site has been affected by prior radiation therapy. Radiated tissue has a reduced blood supply, which can limit how well the transferred fat integrates.
Can fat grafting correct contour issues after lumpectomy?
Fat grafting can sometimes be used to fill divots and hollows following lumpectomy and radiation. However, radiation-related scarring at the lumpectomy site can significantly reduce fat graft survival and limit the effectiveness of this approach. For these cases, we generally prefer local flap techniques — such as the ICAP flap (intercostal artery perforator), TDAP flap (thoracodorsal artery perforator), or IMAP flap (internal mammary artery perforator) — which bring healthy, well-vascularised tissue directly to the affected area.
Does fat grafting increase the risk of breast cancer recurrence?
No. There is no clinical evidence that fat grafting affects breast cancer recurrence in patients who have undergone mastectomy. Studies specifically examining fat grafting into lumpectomy cavities are more limited, and we are happy to discuss the current evidence with you during your consultation.
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