Breast Reconstruction with Fat
Do you have different cup sizes after lumpectomy and radiation?
Breast cancer patients who undergo breast conservation procedures that excise the cancer and preserve the breast often have disparity in breast size. The tissue removed in lumpectomy creates a volume imbalance and the postoperative radiation further shrinks the skin of the already smaller breast. Refinement of fat grafting techniques have led to exciting results for patients with asymmetry due to breast cancer.
Fat transfer to the breast for asymmetric lumpectomy patients is superior to augmentation with implants because the radiation usually causes excessive scar tissue to form around the breast implant or capsular contracture. Fat transfer involves harvesting fat from a donor site on the patient’s own body (family and friends cannot donate) and re-injecting the fat into the desired location or recipient site.
The best symmetry is obtained replacing like with like. Breast is composed of fat and breast tissue and the relative amount of fat in breasts increases with age as estrogen levels decrease. After fat grafting the radiated post-lumpectomy breast, the breast and skin feels softer. The patients are thrilled to have symmetry in their bra cup sizes and less unwanted fat in their abdomen, thighs, or love handles.
During consultation, your medical history, physical exam, and plan are reviewed. Good candidates are 5 years or more from their breast cancer treatment with areas of excess fat on their abdomen, thighs, or love handles. Patient should bring their most recent oncology notes, mammogram and MRI reports. Be prepared to discuss your concerns related to asymmetry as well as your desired outcome. Many patients will benefit from a a reduction of lift on the opposite breast to achieve greater symmetry. I will review these options during consultation to help determine which options will benefit you the most.
