Fat Grafting Can Improve the Look of Breast Reconstruction

Women who’ve had a mastectomy (removal of the breast) may opt for breast reconstruction. Unfortunately, despite advances in plastic surgery, the results can occasionally be disappointing.

According to Ted James, MD, Chief of Breast Surgical Oncology and Co-Director of the BreastCare Center at Beth Israel Deaconess Medical Center, after breast reconstruction, “Women may have contour irregularities — such as indentations, bumps, or ripples — asymmetry, or defects in the reconstructed breast resulting in a disappointing cosmetic appearance.”

For these women, fat grafting is an option for correcting the deformity. It involves removing fat tissue from other parts of the body using liposuction, processing the tissue into a liquid, then injecting it into the site of the reconstruction to help improve contour and appearance. The tissue is usually taken from the thighs, belly, or buttocks. It typically takes four to six individual sessions to get optimum results.

James continues, “Fat grafting has been available for some time.” However, it’s becoming more popular, “because of new and improved techniques that have reduced complication rates.”

Fat grafting results in improved appearance as well as improved “psychosocial well-being, and sexual well-being,” adds James.

To date, fat grafting is not recommended to after breast conserving cancer surgery (i.e. lumpectomy). James explains, “This is still an area of controversy due to concerns about fat cells stimulating potential leftover cancer cells, and therefore increasing the risk of cancer recurrence. Although the data are not conclusive — and in fact, studies suggest that fat grafting may not impact recurrence — the potential risk still outweighs any potential benefits at this time.”

Although fat grafting after mastectomy doesn’t require major surgery, there are some potential disadvantages. The results may not last if the injected fat is reabsorbed by the body. Fat grafting may not be appropriate for all women. And there is a risk of necrosis, a serious condition where the fat injected into the breast area dies.

Of course, many women choose not to have any reconstruction at all following their mastectomy. “Whether or not a woman chooses to pursue breast reconstruction is a very personal choice,” says James. “Many women experience an excellent quality of life without reconstruction.”