Fat-Grafting Lumpectomy Reconstruction St. Louis - Breast Reconstruction Technique Missouri
Technology has advanced to the point where we are now able to fully reconstruct a patient’s breast using their own fat. Dr. Cabbabe was an early pioneer of this technique in Saint Louis and he performs over 100 of these procedures each year.
Dr. Cabbabe uses fat grafting routinely on most breast reconstruction patients in the upper part of the breast and surrounding the reconstruction in order to refine and enhance the result. Dr. Cabbabe is also able to fully reconstruct breasts using your own fat but these procedures are very time – consuming and lengthy, requiring several fat grafting surgeries along with the continuous wear of a vacuum /suction – type device on the breast for months.
Candidates for this procedure include patients who have had a lumpectomy are having a mastectomy or have had a prior breast reconstruction and desire some “fine – tuning” to improve the aesthetic appearance of the breast.
In these procedure, fat is removed from an unwanted area of the body using liposuction. The fat is then purified by one of several methods and injected into the desired site. More than one fat grafting session may be needed in ordered to achieve the desired result. Often times, at least 2 sessions are needed to obtain optimal results.
Antibiotics are given before the procedure and drains are sometimes used. Patients are able to shower the next day and go home in a bra. Early range of motion is done with the arms. Compression garments may be used in the area of fat removal. Patients will generally follow-up within 1 week and then approximately 3-4 weeks later and then in several months.
Recovery is approximately 1-2 weeks depending on the procedure performed on the breast (mastectomy versus revision) and the amount of fat removed. Most women who have this procedure done will be up and about the next day, moving around although they may need pain medication occasionally.
Dr. Cabbabe strives to make the procedure as easy and comfortable as possible for his patients. Before surgery, patients may receive anti-inflammatory pain medications that do not cause bleeding. At the time of surgery, local anesthesia numbing medicine is used that is long – lasting into the breast. After surgery, early range of motion is begun and pain medications are given.
Bleeding may occur after surgery and necessitate a return to the OR. Most women have asymmetry before surgery and minimal asymmetry may be present after surgery. There may be areas of skin that are slow to heal, including the nipple – areola complex. Scars may become thick and irritated and require revision surgery. Some of the fat does not survive and this is accounted for before surgery. Some of the injected fat may not survive and cause fat necrosis or become infected and require further surgery or antibiotics. Rare complications such as blood clots, fat embolism, injury to surrounding structures, pulmonary embolus and death may occur. Revisions may be needed.
Types of Reconstruction:
- Fat Grafting
- Oncoplastic Breast Reconstruction (one – stage)
- Tissue Expander – Implant (two – stage)
- Tissue Expander – Implant with Acellular Dermis (two –stage)
- Implant with Acellular Dermis (one-stage)
- Latissimus Flap (one – stage)
- Latissimus Flap with Expander – Implant (two – stage)
- Latissimus Flap with Implant (one-stage)
- Conventional TRAM (one – stage)
- Free Muscle – Sparing TRAM (one –stage)
- DIEP Flap (one – stage)
- SIEA Flap (one – stage)
- SGAP/LGAP (one – stage)
- Fat Transfer Breast Augmentation
- Breast Implant Reconstruction (One-stage)
- Breast Implant Revision Surgery
- Breast Tissue Expander – Implant Reconstruction (2-stage)
- Latissimus Flap Breast Reconstruction
- Latissimus Flap Breast Reconstruction with Implant (1-stage)
- Latissimus Flap with Implant Breast Reconstruction (2-stage)
- Transverse Upper Gracilis (TUG) Flap Breast Reconstruction