Natural Breast Reconstruction
Breast Reconstruction with Fat Grafting
Large-volume fat grafting offers an alternative to traditional breast reconstruction surgery, and it can also improve the results of an existing breast reconstruction. Innovations by board-certified plastic surgeon Louis Bucky, MD and his colleague Dr. Daniel Del Vecchio have improved the long-term success rate of these procedures, making them safer, more effective, and more reliable. The procedures combine pre-expansion of the skin with fat grafting, resulting in a reconstructed breast with a soft, natural appearance and feel. Fat grafting can be used in primary reconstruction and revision cases, and the specific techniques involved are personalized depending on the needs of the patient.
BRAVA® Prior to Breast Reconstruction with Fat Grafting
The BRAVA® pre-expansion suction device is applied for several weeks in order to gradually create space in the skin, which will be filled during the fat grafting procedure. In many revision cases, fat transfer can improve the appearance and feel of a breast reconstructed with an implant. It can also be used to restore a more normal feel and appearance for breasts that have undergone lumpectomy. The pre-expansion device can be used in a variety of reconstruction and revision scenarios as outlined below, and pre-expansion therapy can also treat a reconstructed breast that subsequently required radiation treatment.
Fat transfer to the breast can be used as the primary reconstruction procedure or can be combined with the use of breast implants.
Breast Reconstruction Without Implants
This option may be appropriate for the following patients:
- You do not want implants.
- You wish to have a small cup size.
- You do not wish to have reconstructive surgery after mastectomy.
In this approach, a pocket is created for the reconstructed breast using either an internal tissue expander or the external pre-expansion device.
Breast Reconstruction With Implants
This approach may be appropriate under the following circumstances:
- You will have only one reconstructed breast (unilateral reconstruction)
- You wish to make your reconstructed breast feel and appear more like your natural breast.
Here, the pre-expansion device is used over the reconstructed breast in preparation for the fat transfer procedure. Fat is injected around the implant, providing more soft tissue coverage so the implant blends into the body more naturally.
Fat transfer can be incorporated into revision procedures to improve the feel and appearance of the reconstructed breasts.
SIEF Procedure for Revision
This revision surgery may be appropriate in these cases:
- You have small or moderately sized implants.
- You suffer from capsular contracture, rippling, or simply prefer to remove your implants.
In this procedure, the implant is removed and the volume is fully replaced with autologous fat.
Partial SIEF Procedure for Reconstruction Revision
This procedure may be appropriate for the following patients:
- You have large implants.
- You have capsular contracture, implant rippling, or simply prefer to have your implants removed.
In this staged procedure, the large implants are exchanged with smaller ones and the volume is replaced with fat. In a subsequent procedure, the smaller implants are removed and fat is injected to replace the volume.
This revision procedure may be appropriate for these patients:
- You have had a TRAM (transverse rectus abdominis myocutaneous) breast reconstruction.
- You wish to increase your cup size.
The pre-expansion device is used to create space in the breast for the fat transfer.
This procedure may be appropriate for patients who desire implant exchange for the following reasons:
- Your implants need to be replaced.
- You want your breasts to remain the same size.
- You want a more natural look and feel.
Before an implant exchange, the pre-expansion device is worn. Fat grafting is performed over the new implants to add natural softness.
The pre-expansion device can be very beneficial in restoring a more natural appearance to a breast that has undergone lumpectomy. The BRAVA® device creates space for the transferred fat, which is injected to the affected area(s) of the breast.
Treatment for Post-Mastectomy Radiation
The pre-expansion device can be used to restore softness and suppleness to a reconstructed breast that later required radiation treatment. BRAVA® therapy helps improve the blood supply to the reconstructed breast, which reduces the firmness of the irradiated breast.
Contact Our Office
For more information about breast reconstruction or breast reconstruction revision with fat transfer, please contact our office to schedule a consultation with Dr. Bucky.
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