Lipo-flap Breast Reconstruction with Autologous Fat Transfer (LAFT Procedure)


The lipo-flap or lipo-bed approach to breast reconstruction can be used when a woman has a limited amount of fat and is not able to achieve the desired breast implant size with fat alone. Traditional flap and implant reconstruction uses a combination of an implant covered by a muscle flap such as the latissimus muscle. The muscle flap serves to thicken the tissue covering the implant so that the implant is not directly under the skin which may be very thin after a mastectomy. Particularly when the area has been treated with radiation, the tissues may be particularly scarred and thin, with a high risk of complications such as implant infection and exposure. There is also an increased risk of complications, even when a muscle flap is used.

Instead of using a muscle flap the tissue quality and thickness can be improved with fat grafting, before placing an implant. Particularly in the face of radiation, the quality of the tissue can be significantly improved, changing from a scarred, hardened tissue to a a much softer, more pliable tissue. Once the quality and thickness of the tissue has been restored with fat grafting, the implant can be placed with a much more natural result and lower risk of complications. Women who have completed implant reconstruction after mastectomy often have poor overlying skin quality, implant rippling, and an unnatural feel and appearance. Even without removing the implant, fat grafting over the implant can significantly improve all these problems.

For women who do achieve a good reconstruction with fat alone, but choose to be still larger, an implant can still be placed if desired. The benefit of this approach is that the tissue over the breast is of a much better quality, and the implant procedure becomes a simple breast augmentation procedure and not a more complex and complication prone implant reconstruction procedure.The MRI images below are an example of the lipoflap procedure to improve the results of breast implant reconstruction. The first before image shows large breast implants directly under very thin skin. The implants feel firm and uncomfortable with poor shape and appearance. With 3 staged autologous fat transfer procedures, a full, thick, soft tissue over the implants was restored. This resulted in soft, normal feeling breasts, with greatly improved shape and appearance.




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