Is it safe to use fat grafting for breast revision or reconstruction surgery after breast cancer?

Dr. Benny Tan is a board certified plastic surgeon specializing in breast reconstruction at Banner MD Anderson Cancer Center.

Question: Is it safe to use fat grafting for breast revision or reconstruction surgery after breast cancer?

Answer: Harvesting fat from the lower abdomen, hip area or thighs is a very useful technique for breast reconstruction and revision. The approach is used frequently in the U.S. and throughout the world. Fat grafting helps fill in areas where there are breast deformities or issues with the shape, balance or position of the breast. This process can make the breast appear more natural.

The tissue used in fat grafting is typically removed from other areas of the body through liposuction. The tissue is processed into a liquid and then transferred into the breast by injection to address any areas of asymmetry in the breast. This approach is called autologous fat grafting. Another option, called lipofilling, is used to address any minor differences in a reconstructed breast as compared to the original breast. The fat injected into the breast can be reabsorbed by the body over time, causing the breast to lose some volume. Thus, a surgeon may transfer more fat than is necessary to compensate for this possibility.

Fat grafting is widely accepted as a safe procedure in patients with a history of breast cancer. Sometimes not all the fat cells will survive from the graft, a condition called necrosis. The necrosis may manifest as calcifications, cysts or lumps. These cell changes may be picked up by mammograms, but usually the findings are different in appearance than breast cancer cells. It is important to have a mammogram prior to the fat grafting procedure and also following it to document any existing abnormalities or emerging changes within a breast.

Women who undergo fat grafting should closely follow their doctor’s recommendations for regular breast screenings to monitor any breast changes and respond to them in a timely manner. Any changes that are suspicious can be evaluated further as necessary.