Can you get good breast reconstruction results without expansion?

No. Simply put, fat is not an expander. Just injecting fat cannot significantly stretch the tight mastectomy tissues. to give you a nice breast mound. We cannot expect the injected graft to significantly enlarge the tissues and at the same time acquire the blood supply required for its survival. If we pack it too tightly it will choke and not survive. The best chance of getting it to survive is to sprinkle a fine mist of fat droplets inside a recipient site that has already been expanded. The fat will then passively occupy the edema space created by expansion. Best grafting results are achieved when we expand the recipient to accept the larger graft amounts.