Miami Breast Center

Quality of Life After Breast Reconstruction: Fat Transfer (with External Expansion) vs Implants

Andre
At the Miami Breast Center, we specialize in natural breast reconstruction using your own fat (AFT) with an external expansion device. For many eligible patients, this approach can deliver a soft, natural feel with minimal scarring and no foreign objects.

Why this matters

A randomized clinical trial published in JAMA Surgery compared total breast reconstruction using Autologous Fat Transfer (AFT) with an expansion device to implant-based reconstruction after mastectomy. The study reported better patient-reported quality-of-life outcomes (BREAST-Q domains) for the AFT group at follow-up. 👉 Read the JAMA Surgery randomized trial (DOI)

Your reconstruction options—at a glance

  • Fat Transfer (AFT) with External Expansion Uses your own living tissue. No implants. Minimal scarring. Natural look and feel.
  • Implant Reconstruction Silicone or saline device placed under the skin/muscle. Requires future surveillance and may need revisions.
  • Flap Reconstruction (Autologous Tissue Flap) Moves tissue from another body area (e.g., abdomen/back). Larger surgery and scars at donor site.

Why we favor Fat Transfer (when eligible)

  • Natural tissue: warm, soft, and part of you
  • No foreign body: avoids implant-related maintenance or removal
  • Minimal new scarring: tiny entry points for micro-grafting
  • Body contouring benefit: fat is harvested from areas with excess

Who may be a good candidate?

  • Seeking a natural, implant-free reconstruction
  • Adequate donor fat and healthy skin envelope
  • Medically cleared by oncology and surgical teams
Every case is unique—oncologic safety and timing with your cancer care come first. We’ll coordinate with your team.

How AFT with external expansion works

  1. Gentle expansion prepares the breast skin and tissues.
  2. Micro-grafting of your purified fat is performed in sessions to build volume safely.
  3. Shaping and refining continue until the desired, natural contour is restored.

FAQs

Will I need multiple sessions? Often yes—staged grafting helps the fat “take” and preserves natural softness. Is sensation preserved? Many patients report more natural sensation compared with implant reconstruction, though results vary. What about radiation? Prior or planned radiation affects candidacy and timing; we’ll discuss options tailored to your case.

Talk to our team

Choosing reconstruction is personal. We’ll walk you through your options and design a plan that fits your goals and medical needs. Request an appointment or call us at (305) 365-5595.

Reference

Piatkowski AA, Wederfoort JLM, Hommes JE, et al. Effect of Total Breast Reconstruction With Autologous Fat Transfer Using an Expansion Device vs Implants on Quality of Life Among Patients With Breast Cancer — A Randomized Clinical Trial. JAMA Surgery. 2023. Read on JAMA Surgery (DOI)
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