Fat Transfer to Breast
For some women, fat transfer (also known of as fat grafting), may be the ideal choice for breast reconstruction, as this provides a more natural enhancement of their breast volume. The ideal patients for this procedure have lost a small amount of breast tissue following a lumpectomy (wide local excision) or in some cases, have already had a reconstruction, such as a DIEP flap and need some hollow areas filled. The transferred fat provides a moderate increase in volume, but can be used to sculpt a more aesthetically pleasing breast shape. The transferred fat is ‘living’ and therefore long-lasting and cannot be ‘rejected’ due to a foreign body allergic reaction. The added liposuction performed on other areas of the body is a bonus to this procedure.
Mr Ghattaura has a specific expertise in fat transfer procedures, though his NHS work with breast cancer patients, who often require fat transfer to their breasts following cancer removal or reconstruction.
What’s involved in the procedure?
The fat transfer procedure is essentially two surgeries, liposuction and a breast augmentation, combined into one. The fat is first removed from one part of your body with liposuction and then re-injected into your breast, where it takes ‘root’, by developing it’s own blood supply. To start with, you must, of course, have enough fat stores elsewhere to be a candidate for this procedure. Mr Ghattaura will carefully evaluate these areas with you in clinic, before surgery, and then mark these up with you on the day of your operation. Common sites are the tummy, hips and thighs, although any area that bothers you can be considered.
The surgery takes round 2-hours and is performed under a general anaesthetic (with you asleep). The fat is first removed with a standard mechanical liposuction machine, although Mr Ghattaura also uses the Bodyjet system, a water-assisted liposuction device, which removes fat far more gently. With the standard liposuction, tumescent fluid is first injected into the fatty area, to loosen the fat cells and reduce the bleeding. This mixture also reduces pain and aims to preserve the structure of the fat cells. After injecting the tumescent fluid, Mr Ghattaura then passes a cannula (suction tube) though the skin, via small ‘keyhole’ incisions. Light suction and a gentle back-and-forward motion is then used to remove the fat cells as well as some of your body fluid. This mixture is then refined into almost pure fat cells, by removing the excess body fluid and other impurities. The processed fat cells are then re-injected into the designated area of your breast. At the end of surgery, Mr Ghattaura closes the incision sites with dissolvable stitches and applies small dressing. You’ll then be asked to wear a compression garment for 6-weeks after surgery, day and night. The scars from the surgery (liposuction and fat injection) are very small and should heal to be nearly invisible.
You should expect some soreness typically from the liposuction site, but this can be easily managed with simple pain medications. You may resume light activities the day after surgery, but it is important to avoid strenuous exercise and heavy lifting for 4-6 weeks. Most patients return to work after the second week.
You’ll be asked to wear a compression garments on the liposuction site, for 6-weeks following surgery, to reduce swelling and pain but also to support your tummy. The bruising normally subsides within one month, The initial swelling from the procedure may cause your breasts to look larger and feel firmer, and will gradually settle into its final state over 3-6 months. The overall amount of fat increase that you see in your breast at this 6-month point will remain permanent and will only fluctuate proportionately to any future weight changes.
Although fat transfer provides a smooth, natural result to your breast reconstruction, it is important to have realistic expectations about the amount of volume increase that can be achieved. This procedure does not have the large volumising capabilities that breast implants do and may need to be repeated.
Available at HMT Sancta Maria, Spire Cardiff Hospital, Nuffield Health and BMI Werndale