chest/pec implants for men

[michaelmorey]

if too much fat was removed from one side of the chest (the lower inner quarter of the right side) are chest implants an option? I hear it's difficult to inject fat successfully into that area of the chest...is that true?
can chest implants be used where there is too litttle fat?

thanks

[Dr. Elliot Jacobs]

I do not feel that pec implants are a good answer for a limited, discrete area of over-resection of tissue.  Rather, I do think that fat grafting is a better choice -- it can be tricky but it is definitely more versatile and if successful, will provide you with soft, natural feeling tissues.

Elliot Jacobs MD, FACS

[michaelmorey]

thanks so much for your answer Doc.  Can u answer these for me:

1) If fat were to be taken from my lower abs, could it be taken with a blood supply still in tact and put in my chest?

2) If the above answer is "no", then does the surgeon simply suck fat out of my stomach, and inject it into my chest, then massage it into place/shape? how does he ensure it stays where it's supposed to be etc?

3) Can a fat graft be done through an armpit incision? (note, that the area to be filled is on the lower left quarter of my right pec, toward the middle of the chest)... (I know it would have to be individually evaluated, but I'm just wonderinhg if it's possible, or in your experience must it be through the areola)

4) If it must be done through the nipple, then does the entire areola have to be removed in order to get acess, and then sewn back on?

What are the risks/most common ways that this procedure could go wrong?

many thanks in advance..I'd really appreciate answers to these questions.

[Dr. Elliot Jacobs]

Fat grafting is a minor surgical procedure and it can be done under sedation anesthesia.  The areas of fat donation and fat grafting are injected with local anesthesia.  Fat is "harvested" from some other area of the body, such as the lower abdomen, love handles, inner thighs, etc.  This is done basically with a syringe and needle.  The fat is then cleansed and injected, a little at a time, through a needle into the area where there is a contour deformity. No incisions of any kind are needed or necessary -- just a needle stick through the skin adjacent to the area of deformity. Usually we like to "over fill" just a bit -- anticipating that some of the grafted fat may not survive. No massage is necessary and the fat remains in place if the technique is done right. There is no way to move fat while still attached to its blood supply (except in very rare and specific circumstances).

There is very little downside to this procedure -- there will be swelling and firmness and bruising for a while.  What cannot be guaranteed is how much fat will ultimately survive.  Evaluation of the results of surgery should be done at about 3-4 months post op and if necessary or desired, another fat grafting procedure may be indicated.  Usually, once fat "takes" in its new location, it will remain there indefinitely. And once fully healed, it is soft and natural to the touch.

Elliot Jacobs, MD, FACS

[The_G0rn]

Nasty.  This reminds me of the ren and stimpy episode where ren gets pec "implants" from the fat off stimpy's butt. 

I believe it was called "Rens Pecs"

[michaelmorey]

lolololol @ the gorn. that really made me chuckkle!!.

Dr Jacobs,
Thank you soooooo much for your answers. I really find that your answers are so informative and directly address the questions asked. You cannot underestimate how much that puts a person's mind at rest. I feel A LOT more comfortable about my situation now, as I thought I'd have to have an areola incision. Keep up the GREAT support doc!

a few more questions I'm afraid!
 
1) how long does it take on average for the fat to "take" in the chest?
2) Am I able to excercise (light weights/cardio) before the fat has "taken" or would this affect potential recovery and reduce the likelyhood of the fat "taking" (i.e, would doing cv excercises increase the likelyhood of "burning off" the fat that had been grafted, if it hadn't yet taken? once "taken is there also any risk of that?

3) I understand that a syringe will be used to inject the harvsted fat into the chest..but when harvesting fat from lower abs, would he probably use the tumescent method to get the fat out before washing it, or would the drugs used in that method contaminate the fat too much? or is it LITERRALY a case of sticking a syringe into my lower abs and sucking out the fat? How is the fat harvested, and what sort of scar would that be likely to leave?

4) Does compression hinder recovery of a fat graft? I ask because i may also need a standard revision (to flatten the nipple and reshape the outer part of the right pect (it's the inner part that pec which needs the graft), as well as a little gland and lipo on the other pec, after which, I'll probably have to be in a compression garment. Could all this be done in the same operation?or would i need to do the revision first, let that heal for 6months, and have the fat graft after? (what would you do in that scenario?)

4a) If the op could be done all at once, does wearing the compression garment post op, hinder the healIng/"taking" of the fat graft?if so, any suggestions?

5)any other factors that hinder/assist the taking of a fat graft? (diet, foods to avoid/promote, vitamins that help/hinder)

6) just as black people are more prone to keloids, is there any evidence that grafts tend to "take"/heal more or less successfully depending on ethnicity? (I am black)
 
thanks again, so much..

(ps. I understand once again that you can't give specific advice without a personal evaluation, but am just looking for ballpark answers, based on your opinion, knowledge and experience...just to give me some idea)

[Dr. Elliot Jacobs]

First, race has nothing to do with the way you would heal after fat grafting.

If you feel that addition lipo and or nipple excision of gland may be necessary, these may possibly be combined with fat grafting -- you just don't want all the areas under the skin (of addtl lipo and fat grafting) to be contiguous.  Yes, a compression garment should be worn for at least several weeks and I would advise no cardio-type exercise for several weeks as well.  There are no special diets, meds, etc which will help or hurt the results of your surgery.

Re the grafting itself -- each doctor's methods are slightly different -- would discuss the intricacies of the procedure with your surgeon.  Graft "take" is a slow process -- new blood vessels have to grow into and around the grafted fat -- and that takes weeks.  BTW, when fat is harvested by a syringe, there is no scar produced!

Elliot Jacobs, MD, FACS

[michaelmorey]

thanks doc. you're a real star!! by the way, do you have any links to pics of any of your previous work that may have involved fat grafting in the chest? or how the lower abs look after fat has been syringed from there? i'd be really interested to see. (as i do have some stubborn lower ab fat, so could it flatten after harvesting?

cheers..

 

[Dr. Elliot Jacobs]

I do have some photos -- but they are in my office photo album.  Fat grafting does not show up well on internet photos -- and besides, I never have to do grafting on my own patients.

If fat is harvested from your lower abs, there will probably be no perceptible change in them. If you do have a collection of fat there, then limited liposuction would be the answer.

Dr Jacobs

[goingcrazy]

Hi Dr Jacob,

How come the photo doesnt turn up well? Is it due to the fat been injected being unnatural?

Also, will there be irregular absorption that might seems to create impression of a lumpy appearance?

[Dr. Elliot Jacobs]

Most fat injections are done for minor contour irregularities -- the before and after photos are subtle and oftentimes do not reflect the real changes in contour as dramatically as some other gyne photos.  The fat grafted areas tend to look and feel soft, natural and smooth.

Dr Jacobs

[goingcrazy]

hmm.. once the fat settles in, will working out burn off these fats and further injection will be needed? or if i were to put on weigh, will the grafted fats accumalate more fats from the weigh gain, as in a point for fat to grow on?

and also i read somewhere that fat harvested from different sites have different survivability rate. How true is it? or anywhere where fats exist can be use for this particular procedure?

[Dr. Elliot Jacobs]

Once fat grafts have healed, they act like normal fat, responding to weight gain and weight loss just like any other fat tissue.

Dr Jacobs

[goingcrazy]

so this procedure isnt a permanent solution and a person with high metabolism rate isnt really very suitable i suppose?

[Dr. Elliot Jacobs]

No, you are just plain wrong.

Dr Jacobs