Structual Fat Transfer (Fat Injection to the Breast) Musgrove Park Hospital is part of Taunton and Somerset NHS Foundation Trust. Patient Information

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1 Structual Fat Transfer (Fat Injection to the Breast) Musgrove Park Hospital is part of Taunton and Somerset NHS Foundation Trust Patient Information

2 Introduction This information is for patients undergoing structural fat transfer (fat injection/lipofilling) to the breast. It explains what happens during the operation, outlining the benefits, alternatives and risks of surgery. If there is anything you do not understand or you have further questions or concerns, please speak to one of the Breast Care Nurses or your surgeon. What is Fat injection? Fat injection has been performed worldwide for over twenty years. This procedure involves taking fat (liposuction) from your tummy wall, thighs or buttocks, preparing this fat and then re-injecting it into your breast. Your surgeon will discuss with you the most appropriate part of your body from which to take the fat. Who would benefit from Fat injections? This procedure is usually performed in patients who have developed an indentation in the breast following lumpectomy (wide local excision) and radiotherapy for breast cancer. We also use this technique in patients who have had breast reconstruction in whom the shape of the reconstruction may be improved. This procedure is also used in men who have developed a deformity after surgery for gynaecomastia (enlargement of breasts in men). Worldwide, fat is also being injected for cosmetic reasons into faces, hands and other areas of the body to improve appearance. What are the benefits of Fat injection? The benefit is to improve the appearance of your breast after surgery (wide local excision or reconstruction). 2 Musgrove Park Hospital Patient Information

3 Are there any alternative treatments available? Your surgeon will discuss all treatment options available to you at your consultation. These options will depend upon your individual circumstances. Before the operation If you are a smoker it is advisable to try and stop smoking to reduce the risk of surgical complications. If you are on Tamoxifen you should stop taking it 1 month before your surgery. If you are taking aspirin you should stop taking it 2 weeks before surgery. If necessary, blood tests may be arranged together with a chest X-ray and/or ECG. The operating surgeon and anaesthetist will see you on the day of your operation. The surgeon will make some markings on your breasts and on the area having the fat removed. You will then be photographed prior to the operation. You are advised to bring in a soft supportive bra to wear following the surgery. The operation Fat is removed by liposuction from the area of your body agreed with your surgeon before the operation. This involves making several small cuts into the area undergoing the liposuction and a small needle being used to remove the fat. Once removed, the fat is then treated by spinning it in a centrifuge to separate out the fat cells. These fat cells are then re-injected into your breast to fill the defect. You will need 2 small cuts on the side of your breast in order to inject the fat. The procedure is usually done under a general anaesthetic and you may need to stay overnight. You may need several operations to fill larger defects as it is not possible to replace too much fat in one operation. After surgery You will need to take regular painkillers after surgery. You will be encouraged to get up and move around on the day of surgery. Most patients will go home on either the day of surgery or the morning after with painkillers to take at home. You may have some discomfort in both your breast and the area of your body that has undergone liposuction. Musgrove Park Hospital Patient Information 3

4 Going home You will go home with some dressings in place which are splash proof and you should wear your soft supportive bra (no underwiring) home. There may be some slight discharge from the wounds. You should wear a supportive bra for 4-6 weeks, only taking it off to shower. You are advised to avoid strenuous exercise for a minimum of six weeks. The length of time you need to take off work will depend on the nature of your job but you will need at least to plan for 1-2 weeks. You may experience some shooting pains in the breasts these will ease over the next few months. The breast will be swollen and bruised initially however this subsides in a few weeks. It can take 6-12 months for the scars and shape of your breast to settle. You are advised not to have sex for the week following the surgery as this can cause further swelling of the breast and you should allow only gentle contact with your breast for about six weeks. If you feel unwell with a temperature, vomiting or notice significant redness of the skin on or around the breast or the area from which the fat was taken you should either contact your General Practitioner or the ward, if out of normal working hours, as you may have an infection and will need antibiotics. During the day you can contact either the breast care nurses or your consultant s secretary on the numbers provided at the end of this information Risks and complications All surgery carries some element of risk. Common side-effects can include nausea and vomiting following general anaesthesia. As mentioned earlier, your breast may be painful, swollen and bruised following your operation. Specific complications 1.Haematoma: This is bleeding into the tissues following surgery and can 4 Musgrove Park Hospital Patient Information

5 occasionally lead to patients returning to theatre to stop the bleeding or remove the blood. This can occur in the breast or at the site of liposuction. 2.Infection: This can occur at the site of liposuction or in your breast where the fat has been injected. The signs of infection are redness, swelling, increase in temperature and discomfort at the site of the wound infection. Should the wound get infected, you will be reviewed and given antibiotics if appropriate. Wound infection after fat injection treatment is uncommon and you will be given antibiotics at the time of your operation to reduce this risk. 3.Nerve injury: During liposuction, some of the nerves carrying sensation from the overlying skin may be damaged, and this could result in numbness which is usually temporary but can be permanent. Very rarely some patients may experience altered sensation called paraesthesia (pins and needles) as a result of nerve damage. 4.Fat necrosis: Some of the fat that has been injected into your breast may not survive and can die. This may present as a lump in the breast and will be checked and treated by your specialist. Treatment occasionally involves removal of this lump at a further operation. 5.Repeat procedure: Sometimes the procedure needs to be repeated to achieve the desired effect. 6.Stem cells: It is believed that some of the cells in fat have properties that allow improvement in the overlying skin and tissue texture which is one of the main reasons that this procedure is used cosmetically. It is unknown if these properties can have any adverse effects on your breast cancer but to date no problems have been recorded in the human breast. 7.Mammograms: If you have had a wide local excision for your breast cancer you Musgrove Park Hospital Patient Information 5

6 may be having regular follow-up with mammograms. Fat grafting your breast can produce some changes to your mammogram including calcium spots being seen as a result of the procedure. These can occasionally look like the calcium spots seen in breast cancer and you may then need a biopsy of this calcium. Most of the time however the calcium spots look very different from those seen in breast cancer and can be easily differentiated by a radiologist without the need for a biopsy. Smoking or being overweight adds to any risks. Losing weight and stopping smoking will reduce your risk of complications. Speak to your General Practitioner for advice on giving up smoking and losing weight. Follow-up You will be given an appointment to return to the hospital 7-10 days following your surgery. During this appointment, the dressings will be removed and your wounds inspected. Long-term outlook Fat transfer surgery is usually successful. Self-confidence may be increased and most women are pleased with the results of their surgery. You may lose some of the initial volume of fat injected into your breast and you may need a further procedure to obtain the required volume to fill the defect. Further information The American Society for Plastic and Reconstructive Surgery American Society for Aesthetic Plastic Surgery British Association of Aesthetic and Plastic Surgeons Further information and support regarding breast health is available from: 6 Musgrove Park Hospital Patient Information

7 Contact us Consultant Surgeons: Telephone Numbers Mr. J A Gill FRCS Secretary: Ms A L Thorne FRCS Secretary: Breast Care Nurses: Judy Reeves Jane Boobier Louise Gardiner Sara Myers Miranda Nicholls Karen Triggs Musgrove Park Hospital Patient Information 7

8 MPH_PIL_524/Mr J Gill/Mrs J Reeves/Oct111reviewOct13 This leaflet can be translated, or supplied in large print, braille or audio. Please contact Medical Photography on or patient.information@tst.nhs.uk