Revision Help for Crater Defect and Long Term Considerations

[spooreal]

MY QUESTIONS:
1. Can I gain weight to create fat surrounding the defect to do fat flaps?

2. Do the flaps become a part of my body and stick to the skin just like any other fat on my body, gaining and losing weight just like the rest of my body? Or will it be just a sewn bridge of fat which will not adhere and integrate to my skin/body. I intend to lose the weight again and dont want further defect.

3. If there is a deep crater, will weight gain affect the INSIDE of the crater, ie if there are limited or no fat cells, would NEW fat cells be created, OR would fat only grow around it and the limited areas there are some residual fat cells? Has any doctor experienced the long term effect of craters?

4. Can any member or physician recommend a surgeon who can do the FAT FLAP procedure WELL. I live in Los Angeles and would prefer not to travel. I do go to NYC often also. Kindly message me.

THANK YOU IN ADVANCE.

[Litlriki]

It's difficult to discuss the best approach to deal with your crater deformity without seeing photos, which would also give us some sense of what your body looks like.  You should address the problem at the weight that you live at, rather than lose or gain weight to try and resolve the problem. 

Fat flaps utilize local tissue, which is mobilized and sutured under the skin of the chest to eliminate or minimize irregular contour.  You don't grow new fat cells normally, but fat can be added using flaps or doing fat grafting by injection. 

I think there may be surgeons on this forum in LA.

Rick Silverman

[DrPensler]

1) Yes, however the amount of weight you would need to gain to markedly increase the volume of fat available makes this option not practical. I utilize the fat adjacent to the defect and volume is not typically an issue. As an aside, a photo would be helpful.

2) The fat is part of your body. The fat is also attached to blood vessels which are not completely severed. The fat maintains a vascular (blood) supply and is far more stable in this vascularized state than as a free fat graft.

3) Weight gain would exaggerate the deformation not improve the situation.(Good idea but unfortunately it will not work.)

[Dr. Elliot Jacobs]

Strongly agree with my colleagues.  Gaining weight will not make things better.

Posting some photos would help us help you.

Oftentimes, when faced with a crater deformity, I use fat flaps developed from surrounding fat tissue.  And surprisingly, sometimes what is needed is to carefully perform liposuction of the surrounding tissues (which minimizes the apparent depth of the crater) and then use the remaining fat for flaps to fill in the crater itself -- it works!

And yes, the fat flaps will heal and become part of your body, "stick to the skin" and feel, move and act like normal tissue.

Dr Jacobs