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Summary: Breast reconstruction surgery is part of a deeply personal, often traumatic journey. The fight against breast cancer often involves mastectomy, whether it’s a preventative step or a treatment step. Every woman confronts the loss of breast tissue differently, and those differences need to be respected. At the same time, plastic surgeons are constantly looking for ways to make the entire reconstructive process easier, from the insertion of expander devices to the recovery and pain involved. One novel approach to breast reconstruction follows suit from other plastic surgery procedures: the fat graft.

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Mostly Fat, Which is Good

The breast is mostly fat. It’s designed, among other things, to provide sustenance and protection during trying times, to store fat (energy) for those trying times, and improve a woman’s chances of survival given the hardship of raising a young child (a trying time, as any parent knows). The breasts certainly have taken on a different meaning today and are imbued with all sorts of cultural and social significance, especially when it comes to the definition of femininity. In other words, the breasts can be an emotional topic, and their wellbeing can have a direct impact on the emotional health of any woman. That’s why breast reconstruction surgery has become a significant topic to discuss for those women who are recovering from breast cancer.

Breast reconstruction offers women a chance to reclaim the femininity that may have been unfairly stolen by breast cancer. Usually, when a malignant tumor is found or suspected (or, in some elective cases, when such a tumor is strongly suspected to develop at some future date), oncological surgeons perform a mastectomy to dampen the chances of the cancer spreading. Usually, in consultation with the patient, doctors will determine whether it is wiser to perform a single or double mastectomy. However, once the mastectomy is complete, reconstruction can begin.

Breast Reconstruction Surgery is Not for Everyone

To be perfectly clear, some women are not interested in breast reconstruction. And under no circumstances do we advocate for the pressuring of women to pursue a procedure with which they are uncomfortable. The degree of mastectomy is different for every one, and sometimes there is plenty of tissue left over. Additionally, reconstructive surgery can be a long and painful process, and to many women, it’s simply too soon or too much. We respect those decisions.

For other women, regaining that locus of femininity is a high priority. Recent advances in surgery and in the acceptance of reconstruction surgery by the oncological community means that this process is much more seamless than it used to be. For example, in some cases, when the mastectomy is initially performed, a tissue expander necessary for the reconstruction process is sometimes placed under the tissue during the same operation, limiting recovery time and eliminating the need for another surgery.

Breast Reconstruction Options

And, of course, there are many options when it comes to a breast reconstruction operation, starting with the donor material to use and the type of technique your plastic surgeon will employ. Here are the basics. According to the website of the New Jersey breast reconstruction surgeons at East Coast Advanced Plastic Surgery—who operate a renowned breast reconstruction center, because so much of the fatty tissue of your breast is gone, regular old breast implants don’t necessarily work to replicate a natural feeling in the reconstructed breast. Most often, plastic surgeons use muscle and fatty tissue from your abdomen. The muscle is transplanted to the chest and microsurgery is used to connect the blood vessels of that muscle to blood vessels in your chest and keep blood flowing to needed areas. In cases, where abdominal tissue is not suitable for donation, material may be found in a variety of places, from your back to your legs to your inner thighs to your arms. It all depends on the individual needs and anatomy of the patient in question.

But there’s another type of donor material that’s working well for some women. Fat graft procedures have become quite popular in nearly every arena of plastic surgery. During a fat graft procedure, fat is harvested from an area of the body where it’s particularly unwanted (usually around the belly or the waist). After the fat is harvested, it is purified—and the technique for purification varies, but it’s usually through a sophisticated version of a centrifuge. After purification, the fat is injected into an area where the patient desires more volume. This is popular when it comes to lip augmentation and especially when it comes to butt augmentation.

Fat Graft in Reconstructive Surgery

But it’s also gaining ground in the arena of reconstructive surgery. The procedure is basically the same—fat is harvested, usually from the abdomen, using liposuction. Once the fat is harvested, it is implanted into the reconstructed (expanded) breast. The advantage of these fat graft techniques is that the look and feel of the reconstructed breast is quite natural. The downside is that much of the fat is absorbed into the body after the procedure. This happens with all fat graft procedures (the ratio of which depends on the purification method) to some degree. Sometimes the fat can die off at ratios of around 50%, sometimes it’s higher and sometimes it’s lower. The plastic surgeon can estimate the end result, but never predict it exactly.

Which means that fat graft procedures may require multiple sessions in order to achieve the desired results. That can be taxing for patients, especially as they’re coming out of recovery from breast cancer of mastectomy. It can be a grueling process. However, to some patients, this particular technique is worth it because donation is less invasive and the results look and feel remarkably natural. But it’s not for everyone. And each woman should decide for herself what breast reconstruction path is the appropriate one for her.

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