Oncoplastic Surgery

Lipofilling (fat grafting)

Lipofilling or fat grafting is a procedure in which fat cells removed from one part of your body are grafted into another area that requires increased volume. Lipofilling is a form of fat grafting, which involves transferring fat from your own body to enlarge or reshape the breasts by modifying the volume, shape, consistency and profile of tissues.

Lipofilling is a new breast reconstruction technique recommended for improving defects, symmetry, volume and refinement of soft tissues after breast reconstruction. It can also be used for the correction of scars and whole breast reconstruction.

The lipofilling procedure is performed under local or general anaesthesia. The donor site is first identified and marked – usually abdomen, thighs or buttocks. Fat is aspirated out of the donor site and centrifuged to separate the fat cells from other fluids. This processed fat is re-injected into the breast muscles and fatty layers through fine cannulas. These are injected in such a way that blood supply is easily available for their survival.

As with any surgery, lipofilling may involve certain risks and complications such as fat shrinkage, bruising, bleeding, unwanted skin changes and infection.

Breast Reconstruction

Breast cancer is generally malignant (spreads to other body parts), usually begins in the lobules (milk-producing glands) or ducts (milk-draining passages extending from the lobules to the nipple) and can sometimes occur in the fatty and fibrous breast tissues. Breast cancer surgery involves the surgical removal of a tumour to prevent the spread of the cancer to other parts of the body. The surgical procedure to remove the tumour depends on the size and type of cancer. Your surgeon may excise the tumour as a lump (lumpectomy) along with a portion of healthy surrounding tissue (wide local excision) or remove the completely affected breast (mastectomy). Lymph glands may also be checked for the presence of cancer and removed during these procedures.

To restore the shape of breasts after mastectomy another surgical procedure called breast reconstruction is performed.

Primary breast reconstruction involves reconstructing the breasts immediately after excising a part or complete breast tissue. This is beneficial for the patient since two major surgeries are combined into a one-time procedure. However, immediate breast reconstruction may not be preferred if the patient has to undergo radiation therapy after breast cancer surgery. In such cases, your surgeon may insert temporary breast implants or tissue expanders or perform skin reduction during mastectomy to restore the shape of your breast. Delayed breast reconstruction is then recommended 6-9 months after the last session of radiation or chemotherapy. Delayed reconstruction can be performed at any time following removal of a part or the complete breast if further cancer treatments are not needed. This surgery is performed even after several years following breast removal.

Advantages

Primary breast reconstruction has several advantages over secondary breast reconstruction. They include: