Preventive Mastectomy: Revision Surgery Fat Grafting Pre-Op Appointment

Posted March 7, 2025 by Prairie Wife -

When I find myself in Denver for my pre-op appointment, I always know when it’s getting close to surgery time. Thankfully, the Wyoming weather cooperated when I went down for my Revision Surgery Fat Grafting pre-op Appointment!

Pre-op appointments are pretty simple, especially when you’ve been through as many surgeries as I have. I’ve been lucky enough to work with the same team for the last nine years, making things a lot easier for all of us. I’m already familiar with their expectations, and they know they can count on me to do everything they ask.

You’ll sign a lot of paperwork at these appointments and receive a large folder full of instructions. For my surgeries, we also order any prescription medication I may need at this appointment, so we are ready to go when we drive back down to Colorado for surgery.

I’ve undergone fat grafting before, so I am prepared for the next few weeks.

Before I discuss a few things I think are essential for others undergoing this surgery, I want to give a quick explanation of what will be happening and why I’m undergoing it. Keep in mind that I am describing this without using actual medical terminology in the way that I understood it when the doctors educated me.

When you have a mastectomy, the doctors remove all your breast tissue (and fat) from you collar bone down to the bottom of your breasts. For lack of a better term, they’re scraping it all out and leaving you with skin (top layer) and muscle (bottom layer covering ribs).

If you have under-the-muscle implants, they cut open your chest muscle and place the implants under it in two pockets they create (so they won’t move around). Then, they stitch up your muscles and skin. This is the type of reconstruction I had nine years ago.

If you have over-the-muscle implants, they create pockets under your skin (but on top of your chest muscle) and place the implants there. This is what I now have after my revision surgery.

Beast implants are not solid and smooth round blobs; they have some give and wrinkles. If they were filled to bursting, they would do precisely that if you fell on them or squeezed them too hard.

With a typical breast augmentation, the wrinkles in the implants aren’t seen because the patient’s fat naturally fills those spaces. With a mastectomy patient, there is no fat or tissue to sit in those dents and wrinkles so they can be seen when you move or even if you’re standing still. You can also often see the exact curve of the implant rather than the smooth slope from the collar bone down you see with natural breasts.

Fat grafting aims to take fat (via liposuction) from the patient’s body and inject it into the breast to fill in the wrinkles and dents caused by the implants. The hope is to give your breasts a more natural shape. Fat can be taken from various areas, including the stomach, thighs, and back.

For my surgery, we will try to get as much fat as possible from my thighs.

The primary recovery from this surgery is from the lipsuction. I will have sore legs for 3-4 weeks (nothing new for this long-distance runner), and they’ll look like someone took a sledgehammer to me. My breasts will be bruised as well, but not too tender.

The most challenging part will be keeping “quiet arms” for 4 weeks. For the fat to “stick” in the breast area, it needs to be disturbed as little as possible. Too much arm movement means I could tear the delicate capillaries growing into the new fat. Too much activity results in the fat being absorbed back into the body rather than staying where we put it and creating a more natural-looking breast shape.

So, what must you have to be ready for your fat grafting surgery?

• Loose camisiols and tank tops: For this surgery, you can’t have anything pressing against your breasts. If you do that, it can change the shape of the fat. No bras or anything tight on your chest for 4 weeks.
• Pillows: You must sleep on your back for the first four weeks. Sleeping on your side or stomach will result in a shift of fat tissue that can make an unpleasant shape.
• NO-SEAM Compression Leggings: I’ll need to wear compression leggings for four weeks after my surgery. They’ll keep me comfortable as I move around and help ensure I have a nice shape after the liposuction. The compression also helps with the bruising. If you have fat taken from another area, you’ll need to plan to wear compression garments there as well.
• Colace and Fiber: Surgery always bogs down your system, so start taking Colace and/or fiber the entire week before and week after your surgery to ensure your comfort.
• Protein: Protein helps your body heal after surgery, so make sure you have some on hand. You can use natural sources or protein powder to make smoothies.
• Bromelain Supplements: Taking these the week before and after surgery can help lessen the bruising from the liposuction.

Unlike my last revision surgery, where I had to lay low for 6-8 weeks, this surgery allows me to walk as soon as I want…as long as I keep my arms quiet. I encourage you to get up and moving when you can to help get your body going and to keep yourself from being bored as you recover!

Questions? Let me know in the comments below.

Categories: Preventive Mastectomy, Revision Surgery

Tags: , breast cancer, fat grafting, liposuction, pre op, preventive mastectomy, revision surgery