How to improve Fat Survival after Fat Grafting Surgery

13 Jan How to improve Fat Survival after Fat Grafting Surgery

What to Expect after Fat Grafting to the Breasts Surgery

Fat grafting surgery has become a popular method for breast augmentation, offering optimal results using your body’s fat. However, ensuring long-term success depends on how well the transplanted fat survives.

Perth Specialist Plastic Surgeon Dr. Guy Watts has many years of experience performing breast procedures, including breast augmentation.

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Fat Grafting to the Breasts – Procedure Overview

Fat grafting to the breasts is a surgical procedure that uses your body’s own fat to increase breast size and shape. It involves harvesting fat from areas with excess deposits, such as the abdomen, thighs, or flanks, through liposuction. The harvested fat is then processed to remove impurities like fluids and oils, leaving only the most viable fat cells for injection.

During the procedure, your surgeon injects the purified fat into specific areas of the breasts using fine cannulas. This meticulous process helps reshape and volumise the breasts while ensuring natural-looking results. Fat grafting is often chosen by patients seeking moderate increase, improved symmetry, or reconstruction following mastectomy or lumpectomy.

The procedure requires general anaesthesia and is performed on an outpatient basis. Recovery involves two to three weeks off from work and social commitments.

What Happens to the Fat after It Is Transferred to the Breasts

Once the fat is transferred to the breasts, a natural healing process begins. The success of the procedure depends on how well the fat cells establish a blood supply in their new location. Initially, some fat cells may not survive due to limited blood flow, which is why surgeons typically transfer more fat than needed to account for this expected loss.

The fat that successfully integrates becomes a permanent part of the breast tissue. The body gradually forms new blood vessels through a process called revascularisation, ensuring that the transplanted fat receives adequate oxygen and nutrients.

However, not all fat cells survive. Studies show that about 40-60% of the transferred fat typically remains after the healing process. Factors such as smoking, poor circulation, or inadequate postoperative care can negatively affect fat survival. On the other hand, maintaining a stable weight and following your surgeon’s care instructions can significantly enhance long-term results.

Over time, the breasts may change due to natural ageing, weight fluctuations, or hormonal changes. Still, the fat that survives after the initial healing period becomes a permanent, natural part of the breast tissue, offering soft, realistic results.

Techniques and Recommendations to Improve Fat Survival

Enhancing fat survival after fat grafting surgery involves a combination of precise surgical techniques and thoughtful postoperative care. Here are essential methods that help ensure optimal fat retention:

1. Optimal Fat Harvesting and Processing Techniques

Achieving good outcomes in fat grafting begins with how the fat is harvested and processed. Ensuring minimal trauma to fat cells is crucial to enhancing their survival rate.

• Gentle Liposuction Methods: Using low-pressure, advanced liposuction devices minimises the risk of fat cell damage during harvesting. The goal is to extract fat with as little trauma as possible, preserving its structural integrity.
• Careful Handling: Once harvested, fat must be carefully managed to avoid cell rupture. Specialised techniques, including sterile processing conditions, help ensure that only healthy, viable fat cells are prepared for grafting.
• Low-Speed Centrifugation: This method separates viable fat cells from fluids, oils, and damaged cells. By using low-speed centrifugation, your surgeon can ensure that the fat used for transfer is of the highest quality, maximising the chances of long-term success.
• Minimising Exposure to Air: Reducing fat exposure to air during processing decreases the risk of contamination and cell dehydration.

2. Injection Techniques

The injection process plays a critical role in the longevity and appearance of the fat graft. Proper technique ensures optimal fat retention and natural-looking results.

• Small Aliquots Injection: Injecting small amounts of fat at a time ensures the grafted fat remains close to the surrounding tissues’ blood supply. This prevents the formation of fat clumps and improves nutrient absorption.
• Multi-Layered Fanning Technique: This technique involves distributing the fat evenly in a fan-like pattern, maximising tissue contact. Layering the fat ensures better integration and creates a smoother, more natural contour.
• Controlled Depth and Placement: Fat must be injected at different depths within the breast tissue to promote integration. Precise placement minimises irregularities and enhances overall breast shape.
• Minimising Over-Correction: Surgeons often overfill the treatment area slightly to account for the natural absorption of some fat cells during the healing process.

3. Recipient Site Preparation

Preparing the recipient site is essential to ensure that the transferred fat survives and thrives. A well-prepared site is more receptive to the graft.

• Ensuring Good Vascularity: A site with a strong blood supply supports the survival of the fat cells. Preoperative treatments such as external vacuum devices may be recommended to enhance vascularity.
• Addressing Pre-existing Conditions: If the site has prior scarring or radiation damage, surgeons may use specific treatments to improve tissue health before the procedure.
• Minimising Tissue Trauma: Reducing trauma during the procedure by using advanced surgical techniques can prevent inflammation and improve healing.
• Preventing Infection: A sterile surgical environment minimises infection risks, creating an optimal setting for fat graft survival.

4. Postoperative Care

The postoperative phase is critical in determining the success of fat grafting surgery. Proper aftercare ensures that grafted fat survives and integrates effectively.

• Avoiding Pressure on the Treated Area: You must avoid direct pressure on the treated areas to prevent fat displacement or damage.
• Following Activity Restrictions: Limiting physical activity during the initial recovery phase helps protect the grafts.
• Maintaining a Stable Weight: Weight stability is essential, as weight fluctuations can alter the appearance of the fat graft results.
• Hydration and Nutrition: Staying hydrated and eating a nutrient-rich diet promotes healing and overall health.
• Regular Follow-Up Appointments: Consistent follow-up visits allow your surgeon to monitor progress and address any concerns promptly.

Factors Affecting Fat Survival

Several factors influence the success of fat grafting procedures, determining how much of the transferred fat survives and integrates into the surrounding tissues. These factors fall into patient-related, surgical, and postoperative care categories.

• Patient’s Overall Health: A patient’s overall health plays a major role in fat survival. Conditions such as diabetes, autoimmune disorders, and circulatory issues can hinder the body’s ability to establish a proper blood supply to the grafted fat. Quitting smoking is crucial, as smoking impairs blood flow and slows the healing process.
• Lifestyle Choices: Maintaining a healthy lifestyle, including regular exercise, a balanced diet, and avoiding alcohol, promotes better healing and fat survival.
• Donor Site Selection and Fat Quality: The quality of fat harvested from donor sites like the abdomen, thighs, or flanks affects how well the fat survives after transfer. Fat from areas with more stable fat deposits generally has a higher survival rate.
• Hormonal Factors and Weight Stability: Hormonal changes related to pregnancy or menopause can impact long-term fat retention. Maintaining a stable weight is essential, as significant weight fluctuations can cause changes in breast appearance.
• Postoperative Care Compliance: Following all postoperative care instructions, including avoiding pressure on the treated area, staying hydrated, and attending follow-up appointments, can help ensure long-lasting results.

Expected Results and Long-Term Maintenance

Achieving successful fat grafting results goes beyond the operating room. Long-term maintenance is essential to preserve the appearance of the breasts after surgery.

Realistic Expectations

You should expect some degree of fat reabsorption, especially within the first few months following surgery. Your surgeon might overfill the treatment area slightly to compensate for this natural loss. Final results become more apparent after about six months.

Weight Management

Maintaining a stable weight is critical. Significant weight gain or loss can impact the appearance of the breasts, as fat cells respond to body-wide changes. Stable weight maintenance helps preserve long-term outcomes.

Healthy Lifestyle Choices

Adopting a healthy lifestyle supports fat graft survival. Eating a nutrient-rich diet, staying hydrated, avoiding smoking, and engaging in regular exercise can improve overall health and enhance surgical results.

Regular Follow-Ups

Routine follow-up appointments with your surgeon are essential. These visits allow your surgeon to monitor progress, address concerns, and recommend touch-up procedures if needed.

FAQs about Fat Grafting to the Breasts

How long does it take to see final results?

• Final results typically appear within three to six months after surgery. This timeframe allows swelling to subside, and transferred fat to stabilise and integrate with the surrounding tissue.

Can fat transfer be combined with other procedures?

• Yes, fat transfer can be combined with procedures such as mastopexy, abdominoplasty, or liposuction. Make sure to discuss your goals and expectations with your plastic surgeon during the initial consultation.

Is fat transfer permanent?

• Once the transferred fat cells establish a blood supply, they become a permanent part of the breast tissue. However, factors such as weight fluctuations, ageing, and hormonal changes can affect the appearance of the breasts over time.

Will I need multiple fat grafting sessions?

• Depending on the desired volume increase and initial fat survival rate, some patients may require additional fat grafting sessions. This approach ensures a gradual, natural-looking increase while minimising overcorrection risks.

Is fat transfer safe?

• Fat transfer is a plastic surgery procedure associated with certain risks and complications, just like any other surgical intervention. Since it uses the patient’s own fat, there’s no risk of allergic reactions or implant-related complications. Proper surgical techniques and adherence to aftercare instructions can further enhance safety.

Who is a good candidate for fat transfer?

• Good candidates are individuals with adequate fat deposits in areas like the abdomen, thighs, or flanks. They should be in good overall health, have realistic expectations, and be non-smokers to ensure optimal healing.

How much fat is needed for the procedure?

• The amount of fat required depends on the patient’s goals and current body composition. Your plastic surgeon will harvest more fat than needed due to the expected fat absorption rate after transfer.

Is the procedure painful?

• Fat transfer involves both liposuction and fat injection, which can cause temporary discomfort. Most patients experience swelling, bruising, and mild soreness, which subside within a few weeks. Pain management plans help ensure a comfortable recovery.

Can fat transfer correct asymmetry?

• Yes, fat transfer can improve breast asymmetry by targeting specific areas for precise volume enhancement. This technique can create a more balanced and proportional appearance.

What is recovery like after fat transfer?

• Recovery typically involves a few weeks of reduced activity, wearing compression garments, and following specific care instructions. Most patients return to normal activities within two to three weeks, though complete healing may take several months.

How long does the procedure take?

• The entire fat transfer procedure, including liposuction and injection, usually takes two to four hours, depending on the amount of fat being transferred and the complexity of the case.

How can I prepare for surgery?

• You should quit smoking, maintain a healthy weight, and follow preoperative instructions from your surgeon. Staying hydrated and eating a balanced diet can also promote better healing and recovery.

Further Reading about Breast Augmentation Surgery

• Read more about Different Types of Silicone Breast Implants
• Read more about How Can I Enlarge My Breasts?
• Read more about History of Breast Implants
• Read more about What Are the Most Natural Looking Breast Implants?
• Read more about What Is Upper Pole Fullness?

Medical References for How to Improve Fat Survival after Fat Grafting Surgery

• Improving Facial Fat Graft Survival Using Stromal Vascular Fraction-Enriched Lipotransfer
• A Systemic Review of Autologous Fat Grafting Survival Rate and Related Severe Complications
• The Efficacy of Cell-Assisted Lipotransfer Versus Conventional Lipotransfer in Breast Augmentation
• Survival Mechanisms and Retention Strategies in Large-Volume Fat Grafting
• Large-Volume Fat Grafting to the Breast With External Expansion Assist