19 - Fat Grafting for Total Breast Reconstruction

Abstract

Fat grafting has been used mainly as an adjunctive procedure in breast reconstruction. More recently, fat grafting has been considered, for total breast reconstruction. In this chapter, we elucidate the principles of free fat graft survival and the techniques that allow a recipient bed to accommodate a large graft amount. Since fat injection has limited ability to expand tissues, the benefits of external vacuum expansion (EVE) are discussed. We will go over preoperative patient selection and education, surgical planning, patient markings, and technical pearls to achieve optimal results in total breast reconstruction.