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Lumpectomy Reconstruction with Coleman Fat Grafts

Posted October 20, 2012 in Breast, Breast LipoStructure, Coleman Technique for Fat Grafting, Minimally Invasive and Non-Invasive Fat Removal

Fat Transfer for a more normal breast after lumpectomy reconstruction

After conservative breast therapy for cancer (lumpectomy followed by irradiation), a woman is left with a lumpectomy defect that is often difficult to reconstruct. The therapeutic irradiation is a critical component of breast cancer treatment to decrease the possibility of the cancer returning near the site of the original cancer. Unfortunately, radiation can damage the normal tissue while it is eliminating potential cancer cells. This damage from radiation significantly complicates lumpectomy reconstruction.

Lumpectomy Reconstruction with Fat as an Alternative to Implants

Placing a saline or silicone gel-filled implant into the damaged, irradiated breast remarkably increases the incidence of scarred or hard breasts (breast capsular contracture), infection and rejection of the silicone implant.  Therefore, placement of an implant in these conditions often results in a poor cosmetic result.

Mechanism of Lumpectomy Reconstruction with Fat Transfer

Lumpectomy reconstruction (putting fat into a breast after lumpectomy and irradiation) not only restores the breast by adding volume and reshaping the breast, but also appears to decrease scarring and promote the growth of a blood supply and the healing of the radiation damaged breast.

Versatility of Lumpectomy Reconstruction after Lumpectomy

Fat can be grafted in either large or small volumes to address otherwise difficult problems such as asymmetry or breast size, poor breast shape, visible implant edges, or even a hard, scarred implant. Grafted fat can provide missing coverage and may also relax breast scarring.   Recent scientific articles have reported on the efficacy of fat grafting for breast reconstruction and improving the shape of the breast as well as for the treatment of radiation damage.

When fat is harvested and refined with minimal trauma and placed in small volumes with each pass of the cannula, a significant portion of the transplanted fat survives and provides a structure and shape to the breast that cannot be achieved with implants alone or with other types of surgery.

Structural fat grafting using this technique appears to be as safe as and perhaps even more effective than many other methods of changing the contour of the breast. Some reconstructive surgeons are claiming that fat grafting may be among the most significant advances in breast surgery.

Patient Example of Lumpectomy Reconstruction with LipoStructure

Lumpectomy Reconstruction after Radiation
Before (right) and 7 months after (left) one treatment of a retracted, deforming lumpectomy scar. After lumpectomy followed by therapeutic radiation, this patient was left with a hard, painful breast. Her breast was so hard, that mammography was not possible. By six weeks after filling the lump and releasing the adhesions, the patient’s pain was almost absent and her breast was soft enough to obtain a mammogram.   Please note the improvement in skin quality of the area around the indentation all the way up to the nipple.
Lumpectomy Reconstruction after Radiation
Before (above) and 7 months after (below) one treatment of a retracted, deforming lumpectomy scar.
Lumpectomy Reconstruction after Radiation
Before (right) and 7 months after (left) one treatment of a retracted, deforming lumpectomy scar. Profile demonstrates a subtle decrease in fullness in the area above the retracted scar. Before fat grafting, the area just above the scar was hard and full. Placement of a small amount of concentrated fat into the area above the retracted scar with surgical release of the scar resulted in a soft breast without the hard protuberant area above (orange circles).

–Written by the Staff at TriBeCa Plastic Surgery


Check out these links for more information on fat grafting to the breasts:

  • Fat Grafting to the Breast Revisited: Safety and Efficacy. Plastic & Reconstructive Surgery. 119(3):775-785, March 2007. Coleman, Sydney R. M.D.; Saboeiro, Alesia P. M.D.

Catherine Saint Louis wrote an article in the Style Section of the New York Times on fat grafting to the breasts on.  Please click on this the following URL to take you to the article:

Ms. Saint Louis did a great deal of research and spoke to me for close to two hours over three different conversations.  She also interviewed one of my patients who has an eleven year follow-up (last paragraph of the article).

© Coleman 2012