Fat Grafting Breast Reconstruction Recovery
Fat grafting after breast reconstruction recovery is a much quicker process especially if you have had DIEP flap surgery. Phase one is typically a six week recovery. The fat grafting surgery is typically day surgery and you will be back home or back at your lodging that evening if you have traveled for the procedure.
I addressed the side effects of anesthesia here. Another post written about post surgical garments after fat grafting can be read here. I wanted to outline some common side effects of the fat grafting procedure and what you can expect in this blog.
Fatigue during Recovery
When you wake up from surgery you will be shaking off the anesthesia and will feel fatigued for a period of roughly a week. This will depend on each individual and the extent of the surgery. We each bounce back at different rates and some fat grafting involves scar revision, nipple reconstruction or some other tweaking that may make that fatigue last a bit longer. My barometer for knowing I’m on the mend and getting my old energy level back is when I no longer need that daily nap. I think it is very important to give into these feelings of fatigue and put your feet up for a mid-day rest. Just don’t sleep too long as it can interrupt your sleep through the night.
Swelling during Recovery
Speaking of putting your feet up! Surgery will naturally cause extra fluid build-up. The plastic surgeon that performs the liposuction during fat grafting will be using a cannula. This cannula is inserted into a part of the body that the plastic surgeon determines has excess fat and will also result in a nice contour to your body after that fat is extracted and put back into your breasts. Fat was taken from my outer thighs and flank area. The cannula is moved back and forth under the skin so it is natural for your body to have fluid buildup during the healing stage. What you will notice is that the swelling is dependent. This means it takes its natural course like any fluid and will flow in a downward direction. You will notice swelling around your legs, knees and ankles over a period of a week or so as this fluid dissipates throughout your body. It may take longer for some patients to get rid of this swelling. Compression garments definitely help with this.
When I returned home from fat grafting I was up about four pounds. This seemed counter intuitive to me since my food intake was far less than what I normally eat while preparing for surgery, the day prior to and the few days following fat grafting surgery. I am certain the weight gain was the buildup of the extra fluid. I remember waking up one day about a week after surgery absolutely famished. I stepped on the scales and those four pounds were magically gone and my legs were no longer swollen. No more cankles! Elevating your feet at night with pillows or during the day while napping will help alleviate some of the swelling but you will just have to wait for it to go away. Some may return to work a week or two after surgery. While sitting or standing all day you may notice excessive swelling. Again, wearing the compression garments will help. Rotating your ankles will help. I even wore compression stockings a week or two after my surgery to help with the excess swelling.
Bruising and Tenderness during Recovery
You will be visibly bruised after fat grafting. I was told this during my pre-operative consult. I knew I would be bruised and there were no surprises when I saw my Technicolor thighs and back side. It is a bit dramatic and covers a large area depending on where the fat is taken from. Again, it will last for a couple of weeks and will dissipate over time. There will be definite areas of tenderness. Honestly, I had more pain after fat grafting than I did phase one of my DIEP flap. I do want to explain when I had that pain. Quite simply, it was when I got up and down out of bed, from a sitting to standing position or getting in and out of the car. I could be walking, standing or sitting and I was in absolutely no pain. But, the minute I had to get up; BIG OWIE!! It is worth noting that I took one pain tablet the night I had my surgery and was back in my hotel room. I personally feel it’s important to control pain but in this instance, when the pain was only getting up and down, I didn’t feel a need to take pain medication for that reason. I like to ween myself off of pain meds as soon as possible to get my head clear after surgery.
I remember going out to lunch and some brief shopping with my sister the day after my first fat grafting. She is a nurse and was looking at me a bit sideways and kept asking, “Are you o.k.? Are you sure we should be out and about?”
I told her I actually felt better walking around. It was only when I sat down to eat and had to get up out of the chair that I would wince in a bit of pain.
Lumps and Bumps during Recovery
I woke up one morning about a week after my surgery and above my knee was a knot about the size of my palm. I want to point out that if this area had been warm or hot to the touch, red or hard I would have been concerned and you should be as well. Any of those symptoms should result in an immediate phone call to find out what is going on. The knot that I noticed had none of those characteristics. I did feel it was worth a phone call to my plastic surgeon’s office, however, just for my own peace of mind. My wonderful nurse asked several questions and determined I needed to get on the massaging routine. Massaging areas that have been fat grafted will help smooth out those accumulated areas of fat that settle a bit after the fat has been extracted.
I have a three pronged device from Brookstone that I used for massage. It was also battery operated. It is normally purchased and marketed for back and neck massage but it really did the trick for me on my outer thighs and flanks. I’m not sure it is still sold at the store but something similar can be used. You can also apply direct and deep pressure to the areas that were fat grafted if you don’t have something similar to smooth out any lumpiness that occurs. That knot over my knee re-appeared a couple of times and massaging it took care of it almost immediately. It was kind of like kneading dough!
Your recovery from fat grafting will be unique to your body type and physical shape. I can’t emphasize enough to go into all of these procedures in as good of physical condition as your current health situation allows. I truly do believe it has helped with quicker recovery time for me. Walking, light weights, yoga and my favorite, squats, are all examples of exercise you can do before fat grafting to get in shape.