Sequential Fat Grafting as a Standalone Reconstructive Option Post-Unilateral Nipple Sparing Mastectomy: A Case Report

Autologous fat grafting has been shown to enhance breast, but its use as a standalone treatment for breast reconstruction after mastectomy is underexplored. This case report evaluates the efficacy of fat grafting in restoring breast aesthetics post-unilateral mastectomy and radiation. A 28-year-old female with recurrent ductal carcinoma-in-situ underwent nipple sparing mastectomy (NSM) with radiation, resulting in severe breast scarring, volume loss and nipple-areola complex distortion. She opted for multisession autologous fat grafting to avoid implants and external scars. The patient underwent five sessions of fat grafting, starting immediately after mastectomy, using the Coleman technique. The patient achieved satisfactory volume restoration. This case highlights that fat grafting can be an effective standalone method for breast volume restoration post-mastectomy even in unilateral cases and is oncologically safe. While multiple sessions are required to achieve optimal results, fat grafting offers natural consistency, minimal donor-site morbidity and improved breast symmetry.