Breast Reconstruction

The mainstream approaches for breast reconstruction include one-stage or two-stage methods such as autologous flap transplant or tissue expander/breast implant placement. Autologous fat transfer is also a viable option. However, breast cancer patients tend to be slimmer, which makes obtaining fat more difficult. Moreover, fibrosis induced by radiation therapy would significantly reduce the injection amount and survival rate of fat cells. Thus, only a small population of breast cancer patients is suitable for breast reconstruction using autologous fat transfer. In addition, the skin on the side of mastectomy tends to present with scar adhesion or circulation problems due to previous surgeries. The success rate of using autologous fat alone would be much lower than that in the normal population. The injection amount is limited by the skin condition, making the long-term maintenance of the results more difficult. Patients may need to undergo multiple or phased fat injections to achieve more apparent augmentation results. Recently, some doctors used a BRAVA vacuum device on the affected side of the breast to increase skin elasticity and circulation, which makes the skin expand more for large volume fat injection, but the long-term result is still unverified.

Due to the many limitations presented above, breast reconstruction with autologous fat transfer has not gained popularity and is mostly used as a supplement to other reconstruction surgeries. For example, those with inadequate conditions for autologous fat transfer can consider reconstruction with breast implants first and then use autologous fat to adjust breast shape or fullness. A more recent method involves implant placement along with partial autologous fat injection to increase naturalness and symmetry (hybrid augmentation). The surgery could also simultaneously increase the texture of implants and reduce the chance of presence of implant edges or wrinkles.

Surgical conditions


  • Type of anesthesia: General anesthesia or IV sedation
  • Type of incision: 0.3-cm pinhole incision in the medial or lateral lower breast
    1-cm liposuction incision (belly button or groin)
  • Recovery: 2–3 days
  • Removal of stitches: 7 days

General instructions

No food and water on the day of surgery

  • Stimulation with cold compress or excessive heat should be avoided for 2 weeks postoperatively.
  • Compression or aggressive massage of the breasts should be avoided for 1 month postoperatively.
  • Smoking and alcohol consumption should be avoided for 3 months postoperatively.
  • Dieting should be avoided for 6 months postoperatively.
  • Periodic follow-ups and check-ups are necessary if breast lumps are observed even after 6 months.

Ideal candidates

  • Breast reconstruction patients after breast-conserving surgery.
  • Breast reconstruction patients with breast skin thinner than 2cm.
  • Those with inelastic skin at the site of mastectomy.
  • Breast cancer patients who did not undergo radiation therapy.
  • Those who would like local adjustments after breast reconstruction.

Possible complications

  • Fat calcification
  • Unknown lumps
  • Fat displacement
  • Inflammation
  • Autologous absorption
  • Unesthetic breast shape
  • Unsatisfactory results

Surgical advantages

  1. Avoids the risk and care period associated with breast implants.

  2. The breast with fat injection has texture similar to that of normal breasts.

  3. Supplemental to breast reconstruction with implants to enhance natural appearance and improve implant texture.

  4. Minor adjustment to breast sizes to enhance the symmetry of reconstruction.

Surgical drawbacks

  1. Increase in breast size is limited by the skin and scar of the affected breast.

  2. Higher rate of fat absorption compared with that of normal patients.

  3. More likely to have problems such as calcification, lumping, infection, or inflammation.

  4. Multiple procedures may to be needed to achieve similar results as implants.

Possible procedures in conjunction