Breast reconstruction can be a never ending process. While the results will never be perfect or the take you back to the breasts you had before cancer, I can now share after 5 surgeries how to approach your breast reconstruction with fat grafting and implants feeling confident. Education & confidence are the keys to long-term acceptance of your reconstructed body.
Breast Reconstruction with Fat Grafting and Implants
Before cancer, my breasts were one of my favorite parts of my body. Sure they were huge (36DD) and quite saggy for 27 (thanks to gravity and aging), but I loved them.
I couldn't wait for the reconstruction stage so that I could begin to feel whole again. I saw reconstruction as the answer to my insecurities and sadness about my newly changed body. If you haven't been following me since the beginning you can read more about my previous breast cancer surgeries and reconstruction posts here.
In today's post, I will share my reflections on the journey and lessons learned about how to confidently approach breast reconstruction & fat grafting.
Just like with many things in life, the things we see as the solution for our unhappiness rarely work out as planned.
I started with a single mastectomy on the cancer side, then after chemo I did a prophylactic mastectomy, added expanders and later swapped the expanders for implants.
Each surgery left me with new disappointments, added recovery time and new complications to face.
Now, looking back the road through breast reconstruction was part of my healing but there was a lot more self-love and acceptance work I had to do in parallel.
Ultimately it was blogging, reflection, and lots of self-love practice that helped me find love for my body again.
Why I Chose to Have Breast Reconstruction Revisions & Fat Grafting
Two year's after my first mastectomy on my cancer side, I had a surgery to complete reconstructive revisions and fat grafting (also called fat transfer). The revisions were done to remove extra skin and tissue that made my foobs (fake boobs) look disproportionate. The fat grafting was also done to improve the natural appearance of the foobs by adding fat taken from my stomach and hips to my chest. The goal was a more rounded, natural shape of the breast reconstruction.
For reference my implants are under the muscle Natrelle Inspira Overfilled Round in 750CC (Silicone)
How Does Fat Grafting Work on Reconstructed Breasts?
When going into a fat grafting experience it's important to understand the specifics of how it works so you can have realistic expectations.
The average survival rate for fat grafting is about 60%. You are born with a set number of fat cells and that number never changes. The reason you may gain or lose weight is because those cells grow or shrink. When moving fat around during a fat grafting surgery, the surgeon will go in with a scraping tool (yes that's why it's painful) and remove cells from areas where you have a large concentration. They then run those fat cells through a processing machine to "purify" them and then they inject those fat cells into the new location.
The injected fat cells need enough oxygen and blood flow to survive in the new area. If too many new fat cells are injected at once there is a higher chance the fat cells will die. It takes time to determine what amount of the injected fat cells were survive.
After the fat grafting procedure, you will be expected to wait up to 3 months to see the full results. After the waiting period you can determine if you plan to do another session. Most patients will go through 2-3 sessions to achieve the desired result with fat grafting.
Fat Grafting Breast Reconstruction Recovery
I am sharing my own experience recovering from the fat grafting procedure, keep in mind that each person's healing time and pain tolerance is different.
Fat Grafting Pain & Bruising
When I came out of my surgery I had zero pain on my chest (where the fat was injected and where the skin revisions were done. The locations where the fat was removed from my hips and abdomen were extremely painful though and sore to the touch for about 30 days following. As you will see in the photos below my bruising was quite bad for the first few days but subsided quickly. The tender soreness similar to a bad bruise remained for the full 4 weeks of recovery, but I was able to fully function and was not on pain medication aside from Tylenol. I even started a new job 7 days later.
One of the most important part of the recovery is the medical grade compression you will wear on the fat harvesting sides to help with healing and the blood cell recover (read more on that here). This is the compression girdle I wore 24 hours a day for 4 weeks! My nurse had the fabulous advice to plan the surgery towards the end of the summer/beginning of fall because the compression garments are super hot and sweaty.
Another aspect to the recovery in my particular case was that I did have the typical 5lb weight limitations due to the skin revisions. If you are just having fat grafting done without other revisions, the recovery is normally only 7 days. .
Mastectomy & Breast Reconstruction Results
Fat Grafting Before & After
Fat Grafting Breast Reconstruction Reflections
So you may be thinking... was it worth it? My honest answer is, for the most part yes. While the appearance of my reconstructed breasts is improved, not all of the fat was accepted by my body. The fat grafting and revision helped me have a more natural appearance and fullness to my breast reconstruction.
While I will need more sessions of fat grafting eventually to achieve my desired results, I am tired and done with surgery for the time being. I am preparing to take a break for family planning and hope to someday come back to the reconstruction process in the future.
My plastic surgeon and I will revisit the topic after children and may at that time, assuming my body has changed even more, I may go through additional fat grafting sessions. Maybe in the future, it will become a priority again, but for now I am sticking with this body I have and I am celebrating my reconstructed breasts. Sure there are imperfections but they are all part of my story. I choose to celebrate my strength, my determination and my amazing body that has gotten me through so much.
Breast Reconstruction & Fat Grafting Lessons
When the plastic surgeon first told me the reconstruction process could take up to 2 years, I didn't really understand the weight of her remarks. I thought after the first surgery I would be satisfied and it wouldn't matter that there would be "touch up surgeries" down the line. Now, many years later I reflect and share these lessons with you so that you may have more peace and confidence throughout your breast reconstruction journey.
Be your own advocate
Do your research before reconstruction. Look into a variety of approaches (expanders, immediate reconstruction). Research implant types, sizes, materials, surgery specifics like under the muscle or over the muscle. The more you know, the more questions you can ask and the more satisfied you will be with the results of your surgery. Make sure you are the driving force in the decision making.
This is the hardest part. Expanders take time, recovery takes time and waiting in between surgeries takes time. Immediately after each surgery my world revolved around my recovery, my feelings about my results and ultimately my disappointment. The more I learned to be patient and let me body heal, the less I stressed about the results. In time, I was able to reach a healthy level of acceptance.
Take progress photos
Just like with weight loss, it's hard to see growth when you are looking at yourself everyday. I am so glad that I started taking progress photos at the very beginning of my cancer journey. Those photos help me see how far I have come and how strong I am. They help me celebrate my strength, my beauty and my growth both physically and emotionally.
Live your life
- Sitting around waiting for your reconstruction to be perfect can keep you from living your life. When I finally let go of obsessing over my reconstruction I found I had much more time, energy and interest in living life, trying new things and connecting with others. Our disappointment and self-doubt can hold us back from joy
Wherever you are in the reconstruction process, I hope you find peace and love for your body. No surgery will take back the changes cancer caused, but you deserve to keep going until you have found peace and self-love.
Breast cancer survivor, lover of style, beauty and all things pink! Inspiring you to thrive through adversity.