Fat grafting to avoid implant coming through skin strongly recommended by oncoplastic surgeon

Hi there


I had been diagnosed with breast cancer in February 2015 at the age of almost 28. I’ve had a mastectomy with an immediate reconstruction that involved an expander being inserted enveloped by my peck muscle and some pig skin.


A year later, I was told I can’t get the yearly MRI scan that I would like to check the other breast and arm pits. This is because the expander contains a magnetic disk which is a big no no for the MRI machine.


For this reason only, I have decided to have a permenant implant put in it’s place. My private oncoplastic surgeon has mentioned that she thinks the breast skin around the scar has become so thin that she is worried about the implant coming through the skin due to “wear and tear” of the skin. She recommends fat grafting to help the problem. I really do not want to tamper with or change any part of my body to remove the fat. If completely necessary, my belly would be the place I would be least against taking the fat from.


I would be very grateful if someone had any answers to the following questions please:

  1. I’ve not had any children - if I do decide to have children, will this fat grafting/any possible scar tissues around the belly cause problems?
  2. Is it completely necessary to have fat grafting for someone in my situation - has anyone read anything related to this that send me a weblink?
  3. I am Diabetic and use my belly as an indicator to see weather I have too much fat. Would this have any effect on the way subcutaneous/ visceral abdominal fat behaves during my usual fluctuations of weight?

Thank you all so much for reading through to the end of this! looking forward to your replies :slight_smile:






Hi Minz, so sorry to hear you are going through this at such a young age. I was dx September 2014 (2 years next Saturday!) at the age of 47. I had mx and immediate silicon implant reconstruction. Unfortunately that got infected when I started chemo so it was removed.


I had an expander put in between chemo and radiotherapy May 2015. The exander was always going to be a temporary measure, but when I was ready for it to be replaced with a permanent silicon one earlier this year my surgeon insisted on lots of screening to make sure I was fit enough. I had bone scan, CT scan and 2 MRI scans (6 weeks apart to monitor any changes) whilst the expander and its port were still in place. My surgeon had to send full specifications to the hospitals before they would carry out the CT and MRIs (3 different hospitals) but they were all happy to go ahead.


So I would suggest that you speak to your surgeon/radiography department to get clearance for the MRI scans. However, my surgeon also said that if I wanted to keep the expander in instead of going through another reconstruction, she would simply remove the metal port - this may be an option for you?


I had the expander changed, partly because I had problems with the pectoral muscle bulging just below the collar bone and making me look like Dolly Parton! During the replacement my oncoplastic surgeon decided to put the implant on top of the pec instead of under it as that was the only way she could get rid of the bulge. Because of this I have a very thin layer of skin over the implant which looks lumpy and bumpy. My surgeon said that she (or another plastic surgeon) could do fat transfer under the skin to improve the look but would probably need about 4 goes as they have to do a little at a time. Also there was quite a big risk of damaging the implant because the space between it and the skin is so small.


After lots of careful consideration (and several months) I have decided to leave well alone and if the implant ever becomes incapsulated then I will look at a revision. 


I know I haven’t answered all your questions, but hope my experience may help you with your decisions and discussions with your surgeon. 


Lots of luck xx

Hi minz sorry for the delay - just started a new job zzzzzzz!

I’m currently seeing surgeon and onc privately, but will need to transfer to nhs in December as my husbands health care runs out then.

This was partly the reason I was pursuing the revisions, fat grafting etc as much more conveniently to juggle the appointments privately. But decided that that was not a good reason to rush into things.