Several options exist for breast reconstruction and fat grafting could be one of them. However, it is only indicated for specific cases.
The goal in breast reconstruction is to reconstruct the breast as natural as possible. The footprint of the breast, the projection of the breast and the natural contours of the breast should all be considered in the planning of a breast reconstruction. Essentially, two options are available: an implant or your own natural tissue (autologous).
An implant is a fixed volume. In breast reconstruction it provides the volume and projection of the breast. The most challenging part in breast reconstruction with an implant is sufficient coverage of the implant and from an aesthetic point of view a natural coverage of the implant. An implant can not be positioned underneath the skin as this will result in a higher infection risk and a very unnatural looking breast. Most implants in breast reconstruction are positioned behind the muscle.
The best option to reconstruct a breast is your own tissue. Microsurgical tissue transfer is a standard technique in breast reconstruction but it requires training and expertise in microsurgery. It also leaves a scar at the donor site. An alternative in selective cases is lipofilling but several sessions are necessary to achieve a stable result. The outcome can be unpredictable.