American Society of Plastic Surgeons
For Medical Professionals
2 years ago

Post breast reconstruction

I’ve had a prophylactic mastectomy with silicone implants. My breast are now Mis-shapen bilaterally, with a possible leak. Wondering if I have some options to refill my breast with my own fat, though my breast “capsule” has healed. My breast skin and nipples are still intact and I have a history of radiation to the right breast. My surgery was about 5.5 years ago. Thanks!

Procedure: Breast Augmentation
Location: downsville, LA

Replies 3

Steven Wallach
ASPS Surgeon

It’s always a possibility to be able to replace volume using fat injections. However depending upon the volume required you may be better off with using autologous tissue for reconstruction. Best to be seen in person for a proper evaluation.

Douglas Mackenzie
ASPS Surgeon

If you have a leak, your first priority is removing the implants. Replacing the implants in the face of radiated breast tissue has a higher risk of complications and a suboptimal aesthetic result. Revision reconstruction with fat transfer is often a good option, but it has some important caveats. First of all, there has to be enough fat to harvest; if you're very lean, it's not an option. Fat transfer breast augmentation or reconstruction will typically yield modestly sized breasts. Depending on how big your current implants are, you are likely to have smaller breasts after fat transfer. The amount of fat transferred at one time is limited by how your tissues respond to the injection, and the fact that you have radiated tissue on one side will limit this amount further. It is likely you will need more than one fat transfer procedure to obtain a nice result. Fat transfer often improves the irradiated tissue, another potential benefit from the procedure.

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Susan Buenaventura
ASPS Surgeon
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It sounds like you had cancer on the right and prophylactic on the left? Or was the radiation on the right done for another reason? Implants and radiation can be challenging, and fat grafting and or flap reconstruction is worth considering for the left side. It is also possible to do both sides IF you have enough tissue. Fat grafting will be beneficial for both sides, especially the radiated side. But it may not be enough volume for complete reconstruction of both sides, so discuss additional options with an ASPS plastic surgeon as well. Good luck to you.

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