I had hard rope-like scars under my breasts from the reduction and lift type operation I had combined with the lumpectomy. The scars were stuck to my ribs. I didn't realise this, or that anything could be done about it, until I saw a physio to ease the stiffness in my shoulder and armpit. She did a gret job of softening the scar tissue, and showed me how to massage it myself so I could do it daily. I didn't know that physios could treat scar tissue and I'm so glad I saw her. It helped make my lipfill op a success since the tissue was more elastic.
I had a lumpectomy and scar tissue. There was a one year gap after the end of rads and before the lipofill but that was because of a report that said the graft takes better if you take a while for the blood flow to become more normal post rads. Mine is surely cosmetic. Can't tell when I am wearing clothes at all though it bothers me. Lasting reminder of something I don't want to remember. BS said that she had to breakdown the scar tissue during the first op and now that she has done so, she will be able to go for a better shape in the next op.
This is something which they have only recently funded through the NHS in my hospital, previously I'd have had to have it done privately, but they were working through a list of those who had expressed an interest and I have always been clear that I wanted recon. Not doing this for enhancement of what I had as some people are when they have cosmetic surgery, would just like to be left as near as possible to how I was before!
There is no effect on the BC at all, otherwise I certainly wouldn't have done it. Apparently, if you get lumpiness (if any of the fat cells don't take), it can make it harder to work out if there is a suspicious lump (some people say) but my BS and radiographer poo poo'ed that and said of course they can tell the difference and if they had any concerns they's refer me for an ultrasound to check.
Hope you don't mind a question from another interested party. I had lumpectomies on both sides and wasn't happy with the dents so saw a PS a month ago and discussed the fat transfer option. Problem with me is there is still a lot of hard scar tissue, especially on one side which is a hard lump - have had it looked at 3 times with US and one biopsy, they say OK but the radiotherapy means it may stay that way. PS and I agreed to wait until 2nd year checks, which are about 6 months away, and revisit. Did any of you who have had it have any scar tissue remaining? What was the time between WLE surgery and the fat transfer?
He did seem a bit cautious about doing anything, hinted at how they didn't really know what effect it might have on the BC, but cynic that I am felt that was just cos it was cosmetic and NHS and I look OK in clothes except for SNB scars on both sides which are a bit lower than armpits.
Is there any good websites on the topic? I'm interested in what you are saying about newer techniques too.
Hi LIsa, They do seem to vary. I had my first fat transfer and they too it very cautiously in how much they put in,
BS says it is because it is a new technique for the hospital and she wanted to be sure it took properly. So I will need - at least - a second go, scheduled for late Sept, four months after the first one.
That said, the first lipofill left me with hardly any bruising so I am not too distraught at needing a second. I have asked, and she has agreed, to "go for it" rather more this time.
Can't imagine she would go close to overfilling though...
Not aware of obvious re-absorption this time round, so fingers crossed
Thanks, It's really interesting to hear how surgeons opinions differ. I was originally told I could have fat transfer after diep. I saw the consultant plastic surgeon a few weeks ago and he said rather than fat transfer, he would suggest a further reduction on my good side. (I've already had one reduction. I had this done at the sand time as Mx. As I had huge breasts and it would have been extremely difficult to get prosthesis to match) the thing is my good boob is great. I love the size and I haven't lost any nipple sensation. I suppose I need to concentrate on the diep first. Only 7 weeks to wait now.
I think perhaps this was the point of the original question - how much of the fat is reabsorbed and therefore how much long term size increase do you get for a given volume of fat transferred? And the answer seems to vary from one surgeon to another, what technique they use, and can also depend on whether you had radiotherapy or not.
I had LD without implant and just had first fat transfer which I would say has increased me by one cup size. My PS is scheduled to do at least one more of these ops to keep 'topping' up, so I would think this would increase you by more than one cupsize?
To me the most important thing was that it was done in one operation. Most surgeons seem to expect to have to do it 2 or 3 times and I really couldn't face going through liposuction again if I could avoid it. It was so painful and took such a long time to recover.
CC many thanks for the info having been looking forward to improvement to the breast I suddenly got the wobbles.
Sorry it has taken me so long to reply but couldn't find the thread.
xwelcome x, I had a lumpectomy followed by radiotherapy.
I'm having a diep in October but my PS says he won't be able to get the volume the same as the other breat. He says a fat transfer maybe possible but that it will only increase by one cup size
Is that the sort of increase you've had CC?
P.S. My PS told me that she allows for 30% shrinkage using conventional fat transfer into a healthy breast, and therefore overfills by that much. She allows for 10% shrinkage with stem cell transfer into breast tissue that has been treated with radiotherapy.
Hi xwelcomex, I think we were in touch through this website some time ago?
I can't answer for the other ladies, but in my case I am not talking about whole breast recon. I had a very large lumpectomy, more like quandrantectomy, combined with reduction and uplift. I had 350ml of fat injected into the BC side and 300ml into the healthy side, to re-build me up to a reasonable size. So quite a bit more than a lumpectomy "fill in the gaps", but not a whole breast from scratch.
I have read some info about whole breast recon using fat transer, but only in the US, not in the UK.
Can I ask, are you girls discussing whole breast recon with fat transfer? I have been following the development of this for 2 years but my surgeon insists it is not available in the UK. I've recently found someone who has had it done though and am a bit cheesed off as I'd asked ages ago for a referral to anyone that was doing it. I currently have a very unsatisfactory implant, am not eligible from TRAM/DIEP and can't see the point in LD as in my case it would still require an implant under. I did have radio but didn't even go red despite higher/prolonged therapy and my skin is perfect.
If you ARE discussing whole breast recon (and not lumpectomy fills), it'd be really helpful if you could let me know which hospitals you are being treated at. Ta muchly 🙂 xx
So far (4 1/2 months after the op) I am delighted with the results. I now have a reasonably matching pair of breasts, in proportion to my overall build, with a nice natural feel to them, achieved in one operation.
BUT, I had stem cell enriched fat transfer to my BC breast, and conventional fat transfer to my non-BC breast. This was because the plastic surgeon said that tissue that has had radiotherapy does not take fat grafts very well and needs some help. This stacks up with what my original breast surgeon told me, which is that it would take at least 2 or 3 operations to achieve a satisfactory final result on my BC breast using conventional fat transfer - but she couldn't offer the stem cell enriched version, which is why I then went to a different surgeon.
I was in a lot of pain where the fat was harvested (1.3L from my abdomen) for the first few weeks after the operation and very sore for several weeks after that. It all took a lot longer than I had expected for it to settle down. I was off work for 3 months, after an unsuccessful attempt to go back after 6 weeks, even though I only sit in front of a computer most of the time.
But I seem to have a low pain threshold and when I had an operation on my abdomen several years ago, that also was painful for much longer than the surgeon expected. So being a wimp doesn't help!
I am due to have fat transfer sometime in the next few months. The plastic surgeon will take 1pint of fat from my thigh/hip area. Until the last few weeks I've been pretty up beat about it but now I'm having doubts - what if my body reabsorbs all the fat and my breast looks worse- I have a high pain threshhold but the post op pain of the lipo suction does seem to be quite severe.
Are you happy so far with the results cc.
I had fat transer in March 2012. At my check-up 5 days after surgery the plastic surgeon said it would take 2 or 3 months for re-absorption to occur, but at the 2 months post-op check she said it could take 6 to 12 months. From which I can only guess that the most significant loss is in the early stages, but the final result takes longer.
She also said that it's quite common for the breasts to regain volume in the long term because adult fat cells tend to be killed off in the transfer process, but over time these are replaced.
From my own experience so far, for the first 2or 3 weeks after the operation my breasts were hard and swollen but that reduced in the following weeks. I was a 40C immediately after the fat transfer, which reduced to 38C after a few weeks as the swelling around my abdomen went down (which was where the fat was taken from). My biggest problem by far was pain where the fat had been removed, that lasted far longer than I expected and prevented me going back to work for some time. But I had 1300ml of fat taken, so no wonder it was sore.
I had fat transfer 3 weeks ago and was warned by PX that I would experience dissipation can anyone advise me over what time period this happens over. Mine has reduced from initial operation but I'm hoping I can hold onto what I've still got left! I am scheduled in for at least another one of these ops.