Anyone had autologous fat transfer for total breast reconstruction?

Hi HIJ75

Very complimentary, if annoying, that you haven’t got enough fat for reconstruction!

I was offered this option as an alternative to a lumpectomy and LTAP reconstruction but chose the latter as I wasn’t keen to have 3 or more lipofilling operations under general anaesthetic around 3-4 months apart. Though I think if I hadn’t had the LTAP option, I probably would’ve gone ahead with the lipo.

I found some statistics in my notes - 100ml of fat from eg thighs gives around 40-50ml of viable fat for lipofilling but only 15-20ml of that will “survive” long term.  Hence the need for repeated ops to build up layers. Might also be worth asking how the site responds to radiotherapy if that’s in your plan.

Following my reconstruction, I’ve got a few hollows in my boob that my surgeon has said he can fill using lipofilling so am going to have it done in the summer once they can start doing non-urgent surgery at my hospital. So I’ll be following this thread with interest!

Loffie x

Wow, that sounds amazing! But I do know from having lipofilling - to soften the shape of my DEIP  - that it a percentage of it is lost once transferred. The bruising at the donor sites is also quite horrendous. The last lot I had they took some fat from my inner thighs and, despite wearing cycling shorts to ease the bruising, I was walking very tentatively and had to go back to going up and down stairs sideways for a while.Xxxxx

Hi Moresleep, I’d be really interested to know how long the bruising lasts for and how long it affected your mobility?  Does it make a difference on where they take the fat to how quick/slow the recovery is?  I’m just wondering whether I should delay my surgery to next winter when the weather is rubbish rather than ruin my summer!

Loffie x

Hello Loffie, yes I was told that about 50% of the fat injected will be reabsorbed, hence the need for several procedures to layer the fat on. The main reason I am a candidate is my very small boob size, so we think 2-3 procedures, possibly 4. Any more would be intolerable so wouldn't be recommended.

I was told that the response to the lipofilling varies quite dramatically from patient to patient and they don't really know why. Apparently, some of us find the swelling and bruising horrendously painful and others find it quite tolerable. I was advised to try one procedure and if I found it too much, I could change track and go for an implant, which might still be a better result as the implant would have more fat to kind of nestle into.

The first lot of lipo filling was taken from my thighs and hips.They like to take tummy fat but I had none - all used for DEIP!!  I must admit I woke up in pain and they had to give me a fair amount of pain relief. The following day I felt better but took pain killers for a few days. The areas where they took the fat was very tender for a while but so long as a didn't bump or knock the area it was fine. I had a large area on my thighs and hips which went black followed by all colours thereafter - in keeping with a very bad bruise - and it took a few weeks for it to go. It really looked quite spectacular for a while and I'm glad it was not done during the summer. The second time (last November) the surgeon decided to take the fat from my inner thighs. I mentioned to the anaesthetist about having quite a bit of pain when I came round the previous time so he said he put some anaesthetic in for me which did seem to work as I felt less pain when I woke up. As it was on my inner thighs it was less noticeable but it did affect my mobility more. For about a week to 10 days I had to walk very oddly with my thighs slightly apart. It looked as if I had piles!! To ease the pain (really more tenderness) I also went up and downstairs sideways for about a week. With me, they were only taking small amounts of fat to soften the cleavage area after a DIEP and so far I have had to have 2 lots done. To create a new boob I would have thought it would take considerably more. If possible, definitely do it when the weather is rubbish.Xxxx

Forgot to mention.... I wore support my post DEIP support knickers and a pair of cycling shorts which helped the bruising - the latter to help my thigh areas. It all really helped. XXxxx

This is all very interesting and useful. They will definitely need more, though my boob is very small. I was told that it's a 3 hour operation under general anaesthetic so it's not going to be a spa day for sure. They book in for an overnight stay just in case, but she said if I have the procedure in the morning I might be able to go home. I think I will need anyway between 2-4 sessions, but it's hard to predict the absorption rate as it varies so much. I was told I could go back to work without time off, but that I might want to take at least a week. 

So it's not being presented as an easy option by any means, but for me it does seem like the best route to take as I can't have DIEP and don't like the idea of an implant.

Both times my ops were 2-3 hours and both times I went home that day but I seem to be fine with  anaesthetic. I would think you would definitely need a few days off work. It’s a shame you can’t have a DIEP but as you say this could be an option. Even just having a small amount of lipo done although fine the bruising it is still sore afterwards.Xxxx

Thanks Moresleep, that’s such useful info, thank you. I’m definitely going to see if I can delay until next winter as with treatment all last year and the pandemic, I’m looking forward to an active summer.  It’ll also give me time to cultivate some stomach and thigh fat - any excuse to eat naughty things!

Wishing you well with your treatment HIJ75. I think I agree with you - going down this road as opposed to an implant. Please let us know how it goes 

Loffie x