FAT grafting, lipofilling, autologous fat transfer

Fat grafting, also called autologous fat transfer or lipofilling, is a procedure that is used in the final stages of breast reconstruction to improve the volume, contour and feel of your newly reconstructed breast.

In fat grafting, fat cells are removed from other parts of your body (thighs, belly, and buttocks) by liposuction. The fat cells are then purified and injected into your reconstructed breast to diminish contour irregularities and improve overall shape. This procedure may be done in patients who have had a mastectomy or lumpectomy.

Fat grafting has become popular in breast reconstruction because fat has a similar consistency to breast tissue. At this time, it is not routine to recreate an entire breast using fat. In many cases, some fat injected into the breast area is be reabsorbed by the body over time and the breast may lose some volume. This is why some plastic surgeons initially may overfill the breast with fat. Additionally, some patients may have multiple fat grafting procedures to achieve long lasting results.

Because there are stem cells in the fat, there is concern that the fat could stimulate cancer cells. In 2012, the American Society of Plastic Surgeons issued guidelines for fat grafting in breast reconstruction patients. They reviewed all the scientific evidence and did not find any increased recurrence of cancer in patients undergoing fat grafting. More research continues to be conducted on this topic.

Fat grafting may be done alone or in at the same time as tissue expander exchange to implant or during nipple reconstruction. The length of surgery varies from 2-4 hours. Most patients go home the same day of surgery. You may have pain and bruising at the site the fat was taken from and you may need to limit your activities of daily living and exercise regimen for several weeks.

All surgeries have risks. Talk to your doctor about the risks associated with each procedure.