I love fat grafting. It is an awesome technique to fill areas of the body, and I use it in significant numbers of my patients to fill volume in the face.
Fat grafting to other areas is trickier. Not that it doesn’t work, but that it is trickier. For breast cancer reconstruction using fat grafting, it requires using BRAVA domes (or other expansion domes to stretch the skin). Then you do serial fat grafting to the breast, as you can only fill the breast a certain amount each time. This means multiple surgeries spaced months apart. (Many people need 4-5 surgeries)
You need to have enough fat- so for some of my uber athletic thin Bay Area patients- you just don’t have enough fat to make a good breast. Too aggressive with the liposuction? That can cause issues with poor skin tone, wrinkles, and irregularities in the donor site. I don’t believe in ruining your thigh skin or abdominal skin to get fat for the breast. I do think liposuction can be too aggressive for certain areas and certain skin qualities.
So this article (Feb 2024 Plastic & Reconstructive Surgery Journal) is absolutely believable. “Superior Sensibility after Full Breast Reconstruction with Autologous Fat Transfer.” They looked at patients after fat transfer vs. those with standard breast reconstruction techniques 12 months after the final reconstruction.
The numbers weren’t huge 28 patients vs 34. They found significantly higher skin sensibility after autologous fat transfer than traditional techniques.
My thoughts?
Yes. Yes it makes sense. Fat grafting has been shown to help return breast skin sensation to women who were numb for years after mastectomy. I believe in the stem cells and magic of fat.
But this study is a bit deceiving. Traditional breast cancer reconstruction is done in 1-2 surgeries. Fat grafting breast cancer reconstruction takes usually 4-5 surgeries. You NEED enough fat to do the fat transfer. You need to stretch the skin with BRAVA domes or other newly developed domes to make space for the new fat.
So it isn’t apples to apples. If you have a busy life or just want to move on from your cancer, the time difference isn’t insignificant.
This study also doesn’t look at some of the new breast reconstruction techniques which look specifically to preserve the nerve sensation to the breast skin.
But fat grafting works.