Scarless Breast Reconstruction with Fat

Plastic Surgeon Serving Orlando, Winter Park and Nearby Areas of Central Florida

Breast reconstruction using fat micrografting provides an option for women to restore their breasts without breast implants, tissue flaps, scars or incisions. In Central Florida, plastic surgeon Dr. Jeffrey Hartog has many years of experience providing breast reconstruction with fat to people living in Orlando, Winter Park and the surrounding areas.

Breast Reconstruction after Lumpectomy

After a lumpectomy, a partial mastectomy, a wedge resection or a quadrantectomy, the resulting breast deformity can be devastating to many women. Fat micrografting can be an ideal way to help reconstruct the breast with no scars or incisions, restoring normal shape and symmetry. The procedure is also a 100 percent natural, 100 percent outpatient procedure with minimal recovery and downtime.

In most cases, lumpectomy patients are required to receive radiation to the breast to minimize cancer recurrence. Unfortunately, radiation always results in some tissue damage, which can cause:

  • Deformity of the breast
  • Poor skin quality
  • Tissue breakdown

In the face of radiation, traditional reconstruction methods with tissue flaps and breast implants have a significantly increased risk of complications. Particularly when breast implants are used in reconstruction, the risk of capsular contracture approaches 100 percent. Using traditional methods, a radiated breast is often difficult to reconstruct.

One of the major benefits of fat micrografting is the ability of the grafted fat to actually heal and restore the damaged tissues. This healing capacity of the fat is probably the result of the presence of high concentrations of Adipose Derived Stem and Regenerative Cells within fat. In Europe, fat micrografting is considered the first-line approach to breast reconstruction after lumpectomy and radiation. Even the British National Health Service now recommends stem- and regenerative-cell-enriched fat grafting as the most economical and primary approach to breast reconstruction after these cancer treatments.

Breast Reconstruction after Mastectomy

Plastic Surgeon in Orlando, Dr. Jeffrey Hartog has first-hand experience of the difficulties women have to endure during treatment and reconstruction for breast cancer. Michelle Hartog, R.N., is herself a breast cancer survivor who had to deal with the emotions of mastectomy surgery and make choices with regard to her reconstruction options. With all the options of breast reconstruction available to her, she chose to proceed with the only truly natural approach of fat grafting, avoiding breast implants and complex tissue flap procedures.

You are probably a good candidate for fat grafting if you have had a:

  • "Simple" or "total" mastectomy
  • Modified radical mastectomy
  • Radical mastectomy
  • Partial mastectomy
  • Subcutaneous (nipple-sparing) mastectomy
  • Prophylactic mastectomy

When possible, experienced plastic and reconstructive surgeon Dr. Hartog would like to graft some fat at the time of the initial mastectomy procedure, and can join your cancer surgeon in the operating room to begin the reconstruction process. When you leave the hospital, you will already have a small breast mound. Subsequent grafting procedures are 100 percent outpatient. The technique is minimally invasive without breast implants or additional scarring. After breast cancer surgery the last thing most women want is yet another major surgery. Compared to the traditional methods of breast reconstruction, fat grafting involves only tiny needle-sized incisions, no added scars, no foreign objects and it recreates a natural-feeling breast with the added benefit of liposuction.

Additional benefits of breast reconstruction with fat after mastectomy include:

  • You will keep as close to normal sensation in your breasts and nipples as possible.
  • The procedure is covered by insurance for breast cancer patients.

Total breast reconstruction with fat is a staged procedure that is usually completed in three to five grafting procedures. To minimize the number of procedures, use of the BRAVA® device is strongly recommended to expand the tissues and allow more fat to be placed at each of the subsequent outpatient procedures.

There are a number of benefits of fat grafting over traditional breast reconstruction procedures. There are three traditional breast reconstruction alternatives, and they all involve major surgery with further scars either in the breast area or tissue donor areas. If muscle transfer is involved, there may be additional problems such as muscle weakness or even hernia formation.

The breast implant approach involves the implant placement of a foreign object such as silicone or saline under the muscle and leads to an artificial feeling breast mound. Unfortunately, there are frequent problems associated with implants, including:

  • Infection
  • Extrusion
  • Rippling
  • Capsular contracture

These problems are particularly likely in cases of adjuvant radiation therapy after mastectomy or lumpectomy. One of the major benefits of fat grafting is the demonstrated healing and restorative effects on radiation-damaged tissue.

The latissimus and TRAM flap surgery alternatives involve taking a piece of muscle and tissue from the back or the abdomen and using it to rebuild a breast mound. The surgery is extensive; it requires major incisions and a prolonged recovery. There is also a significant complication rate with these procedures, and the result may have a patchy appearance and still often requires a breast implant.

The DIEP flap procedure also involves a lengthy surgery with the removal of abdominal fat and skin. Though DIEP flaps provide some of the best-looking results, they must be done by a specialist who performs many of these on a routine basis. Otherwise the morbidity, complication and failure rates are very high. And even the best results may feel and look like patch work. This procedure also involves a prolonged recovery time.

With the fat micrografting procedure, the recovery is no more difficult than a routine outpatient liposuction procedure. If LiquidGold™ lipobanking is utilized, subsequent micrografting stages may even be performed under local anesthetic with return to normal activity the following day. Of course there are the additional advantages of no breast implants and no additional scars. As with all surgeries, there is a risk of complications, such as infection, but these are significantly less likely and less complicated than those that can occur with the more major flap and breast implant procedures.

The result is a natural looking breast that feels like a natural breast, skin that has normal sensation, and the additional benefit of body contouring liposuction.

Although liposuction and fat transfers have for years been used to tweak or fine-tune implant or TRAM flap surgery, our procedure involves total reconstruction of the breast with your own fat.

Ongoing clinical studies continue to prove the safety and efficacy of this procedure.

Improving Breast Implant or Tissue Flap Breast Reconstruction

The traditional methods of breast reconstruction have achieved a high level of sophistication, but are frequently associated with significant additional scarring, and significantly increased morbidity and recovery. The more sophisticated techniques such as the DIEP flap can achieve excellent results, but must be performed in centers and by surgeons who perform these procedures frequently. Even so complications do occur, and can range from minor flap loss to devastating total loss of the flaps. Flaps and implants will also frequently still require further work to improve the appearance, and implants may have their own problems with time, including capsular contracture.

Fat micrografting can be used to improve the results of existing tissue flaps and implants, or to completely reconstruct the breast after flap or implant complications.

To learn more about breast reconstruction with fat, please contact experienced plastic and reconstructive surgeon Dr. Jeffrey Hartog to schedule a consultation. The Bougainvillea Clinique provides experienced breast reconstruction to people living in Central Florida, including Orlando and Winter Park, FL.