Many women consider breast reconstruction surgery after having a mastectomy or lumpectomy. As of now, the most common options included saline and silicone breast implants. However, breast reconstruction surgery has made gigantic leaps and comes forward with more natural ways to rebuild the look and shape of the breast. Although the plastic surgeon can work with the breast surgeon at the same time and immediately reshape and restore the natural appearance of the breast with the remaining tissue, and, of course, the areola and nipple, after the cancerous tumor is removed, there are more options for women that do not want to undergo this combination of operations in one go or those that have already had their breast surgery and are now considering breast reconstruction surgery.

Microvascular Free Flap Techniques in Breast Restoration

Until a while ago, most surgeons would use microvascular free flap techniques to have the entire breast reconstructed with the patient’s natural tissue. During this procedure, the plastic surgeon transferred tissue (including fat and muscle) from other body areas, usually from the upper back, the lower belly (“the six pack muscle”) or the rectus, to the breast. However, surgeons are now less in favor of these techniques and prefer more advanced options that leave the muscles intact. One such option is a method called Deep Interior Epigastric Perforator Artery flap technique, where the plastic surgeon transfers skin, tissue, and small blood vessels, but no muscle, from the patient’s abdominal area to the breast.

Fat Grafting

Fat grafting is a much promising technique already widely used by leading plastic surgeons around the world with impressive results. During the procedure, using high end liposuction like SmartLipo™ the surgeon removes excess fat deposits from the patient’s thighs of flanks (the area between the hip and the ribs), purifies it, and then carefully injects it into the breast.

Besides allowing women that have had a mastectomy or lumpectomy to have their breast reconstructed (on re-made in its entirely), fat grafting is proven to be highly effective in patients with breast cancer that have undergone radiation treatment. Being very different from chemotherapy, where drugs are used to treat cancer, radiation therapy is a form of x-ray therapy. The two types of radiotherapy used for breast cancer are cobol-based radiation therapy and linear accelerator radiotherapy. Both come with side effects, which include the burning or darkening of the skin with some peeling over the treated area (in this case, the breast). Moreover, radiation therapy might also cause tightening of the skin, and pain at the mastectomy site. Fat grafting (sometimes, combined with stem cell transfer) is found to improve the pain many women experience after undergoing a mastectomy and improve the appearance of the skin. Therefore, besides helping correct breast volume, contour, and shape deformities, fat grafting is also effective in treating irradiated breast tissue and alleviating pain following a mastectomy.

When it comes to volume loss concerns, it is proven that patients that receive higher volumes of injected fat (>151cc) show significantly slower loss of volume. They also demonstrate greater retention of volume overall than patients receiving less than 50cc fat.

Why Fat Over Other Methods?

Unlike with other techniques used to breast plastic and reconstructive surgery, fat grafting comes with a particular appeal. First, and foremost, fat is an excellent biocompatible filler material that is not only available in abundance within the patient’s body but also a material that can be easily collected and processed so that it can be injected in small, controlled amounts. Where scientists now turn their focus is in developing new techniques that will allow more enhanced harvesting, processing, and placement of the fat in order to deliver even more predictable, reliable, and consistent results.

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