General information

Providing the Best in Natural Breast Reconstruction to Orlando & nearby areas of Florida

What’s involved in the process of breast reconstruction with fat, and who is a candidate?

We frequently get questions from prospective patients enquiring about the process involved with breast reconstruction with fat, how many treatments, insurance coverage etc. Here is a quick summary of the process and the steps involved.

Most people who have had either mastectomies or lumpectomy with radiation, are candidates for breast reconstruction with fat. The only limitations are how much fat can be placed at one treatment, and if the individual has enough fat to achieve the desired size.

So for example, a lumpectomy defect may take one or two fat grafting procedures, whereas a mastectomy defect will take about 4 procedures depending on how big a reconstruction is desired, and the amount of fat available for liposuction and grafting.
These numbers may vary depending on the degree of radiation damage if any.
Obviously we do not want to take more fat than the individual can donate, as we do not want to create any deformities in the fat donor areas. So this is really the only limitation of fat grafting. At our facility we are able to bank fat in our FDA registered tissue bank for repeat grafting procedures to simplify the process.
Depending on the individual situation other procedures can be combined with fat grafting, including breast lifts and reductions for the opposite breast if it is unilateral. Fat can be used to improve the results with existing reconstructions with implants or flaps and fat can be combined with implants. Fat grafting can be used to replace or improve other reconstructions as in the case of a poor outcome with an implant or flap reconstruction.

The object of BRAVA® is to improve the results of fat grafting, so though it is not always essential, the use of BRAVA® is highly recommended to improve the amount of fat that can be grafted at one time and decrease the number of procedures required.

When contacting our office, prospective patients should be ready to provide us with a complete medical and specifically breast history, medical insurance information, and of course any specific questions they may have. Ideally photographs should be provided that allow us to see the nature of the reconstruction needed or other problems, and also the areas like tummy and thighs where fat is available for grafting. Having this information will make it easier for us to answer questions one may have as to how we would proceed.

With insurance information, we will also be able to research your coverage, out of pocket expectations etc. It is a federal law that insurers must cover breast reconstruction, and they do not have the option to dictate the type of reconstruction you should have. There are specific codes available to use for breast reconstruction with fat grafting.

With regard to medical and radiographic requirements it is ideal if we can have clearance from your oncologist or surgeon, that reconstruction is appropriate, and there are no factors that should preclude you from proceeding with reconstruction. If there is any other medical history, this may require medical clearance from your doctor and any appropriate blood tests or other tests may be needed.
For the breast it is highly recommended that we have an MRI of the breast performed within the previous 6 months. Most tests, particularly MRI’s etc can be performed in our area, often at a reduced rate. We are also the first to describe a much simpler and cheaper test, using 3-D ultrasound imaging to monitor fat grafting progress between procedures.

We try to schedule the initial consultation within a few weeks of your request. As a general rule, repeated fat grafting procedures are spaced about 3 months apart, but this may be shortened slightly sometimes, or even extended breaks taken between procedures.
BRAVA® is generally worn 3-4 weeks prior to a procedure and 3 weeks after a procedure. Dr. Hartog participates in the multicenter BRAVA® fat grafting reconstruction study.

For more information, feel free to call or email us at your convenience.

4355 Bear Gully Road
Winter Park, FL 32792