Fat Grafting

Fat grafting, also called autologous fat transfer, is used for both breast reconstruction and cosmetic surgery. In fat grafting, fat is removed from other parts of your body — usually your thighs, belly, and buttocks — by liposuction, and then re-injected into the breast area to improve the contour, shape, and volume. For breast reconstruction, fat grafting is used to provide more coverage over an implant to conceal implant edge ripples or to improve the contour of the breasts. It also is used to improve breast symmetry in patients who have had a partial mastectomy and radiation. There are also individuals who may be interested in using fat to increase their breast size, rather than using implants. In those who desire a small, natural increase in breast size, this may be a suitable surgery for them.  Multiple fat grafting surgeries may be needed to achieve the final desired volume or shape.  It takes approximately three months for the fat to be incorporated into the new area. The final outcome will be variable, depending on the amount of fat available to be removed and re-injected, and the “graft take”, or survival, which is approximately 60-80%. Some of the fat may be reabsorbed by the body which will result in some loss of breast volume over time.

For breast reconstruction patients, Dr. Ho uses fat grafting to:

• Conceal implant edge rippling
• Soften the curves of the breast(s), such as the transition from the chest wall to the breast
• Improve contour abnormalities/hollowing from scars and tumor resection
• Achieve symmetry between the two breasts
• Help prepare radiated mastectomy flaps that will undergo delayed breast reconstruction. Two surgeries is typically necessary to achieve the final outcome.

Patients looking to achieve a small to moderate volume increase or improve breast shape who do not want implant augmentation may be a good candidate for a fat grafting procedure. This allows for donor areas to benefit from liposuction creating better contour in both the donor fat site as well as the receiving site.  It is important to note that the final breast with fat grafting alone will not provide the same aesthetic results as a permanent breast implant. Depending on the final breast size desired, multiple surgeries may be needed.

Fat grafting surgery may be performed in an accredited ambulatory surgical facility or a hospital under general anesthesia.  Be sure to arrange for someone to drive you to and from surgery and to stay with you for at least the first night following surgery.

Although extremely rare, there are risks can occur with any surgical procedure. Some risks associated with fat transfer include: bleeding, infection, contour irregularities, persistent pain, fat necrosis, prolonged swelling, poor scarring, dizziness, scarring (very rare given the small fat grafting incisions), numbness, as well as fat embolism.

Fat Grafting Surgery is performed as an outpatient procedure at the hospital or surgical centre. You will be able to go home after the procedure to recover. In general, most recover well over the first week, and we provide you with all the medication and supplies to help you through this process. Wearing a compression garment often helps to minimize swelling and discomfort to the area that fat was removed from. When thinking about time off work, or away from social commitments, 2 weeks can be a safer window of down time. Heavy lifting and strenuous exercise should be avoided for 4 weeks. Dr. Ho will see you in the office over the recovery period to review all of the important information with you and ensure you are doing well. The final results can appear gradually over the first few months as the fat graft integrates into the new tissue and the swelling subsides. The small incisions continue to fade over the first year.