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Autologous Fat Graft in the Reconstructed Breast: Fat Absorption Rate and Safety based on Sonographic Identification.

Kim HY, Jung BK, Lew DH, Lee DW - Arch Plast Surg (2014)

Bottom Line: However, there remains controversial regarding the efficacy and safety of the practice for reconstructive breast surgery.Calculated fat reabsorption rate was 32.9%.Locoregional recurrence was occurred in 1 patient (0.9%) and the rate was not different significantly with control group (2%).

View Article: PubMed Central - PubMed

Affiliation: Department of Plastic and Reconstructive Surgery, Institute for Human Tissue Restoration, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.

ABSTRACT

Background: Autologous fat graft has become a useful technique for correction of acquired contour deformity in reconstructed breasts. However, there remains controversial regarding the efficacy and safety of the practice for reconstructive breast surgery.

Methods: A retrospective review was performed on 102 patients who had secondary fat grafting after breast reconstruction. Fat harvest, refinement and injection were done by Coleman's technique. All patients were followed up postoperatively within 1 month and after 6 months including physical examination and ultrasonography. In 38 patients, the reabsorption rate was calculated by serial changes of thickness between skin and pectoral fascia in the ultrasonic finding. Locoregional recurrence rate was compared with control group of 449 patients who had breast reconstruction without fat graft in the same time period.

Results: Average 49.3 mL fat was injected into each breast. The most common location of fat graft was upper pole, followed by axilla, lower and medial breasts. During 28.7 months of average follow-up period, 2.9% of total patients had symptoms of palpable mass on fat graft side and ultrasonography identified fat necrosis and cyst formation in 17.6% of the patients. Calculated fat reabsorption rate was 32.9%. Locoregional recurrence was occurred in 1 patient (0.9%) and the rate was not different significantly with control group (2%).

Conclusions: Although further studies are required to provide surgeons with definitive guidelines for the implementation of fat grafting, we propose autologous fat graft is an efficient and safe technique for secondary breast reconstruction.

No MeSH data available.


Related in: MedlinePlus

Complication after the fat graft(A) A 60-year-old woman, who initially underwent latissimus dorsi myocutaneous flap reconstruction, was noted to have fat necrosis at 38 months after fat graft with 150 mL in the left breast. (B) A 43-year-old woman, who initially underwent implant reconstruction, was noted to have a cyst 13 months after fat graft with 49 mL in the left breast.
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Figure 3: Complication after the fat graft(A) A 60-year-old woman, who initially underwent latissimus dorsi myocutaneous flap reconstruction, was noted to have fat necrosis at 38 months after fat graft with 150 mL in the left breast. (B) A 43-year-old woman, who initially underwent implant reconstruction, was noted to have a cyst 13 months after fat graft with 49 mL in the left breast.

Mentions: Complications, including fat necrosis and cyst formation, detected by ultrasonograpy of the fat injection site, occurred in 18 of the 102 patients (17.6%) (Table 2, Fig. 3). No infection or implant rupture was noted. Details regarding each complication are provided in Table 2. The presence of a complication was associated with the volume of fat injected. The mean total volume of fat injected into the breasts was 67.5 mL for those patients who developed complications following the procedure, whereas the fat volume was 45.2 mL for those without complications. Of the 18 patients with complications, 10 had fat necrosis, and 8 had cystic lesions. Among them, only three patients complained of a palpable mass, which led to a biopsy; pathologic examination confirmed as fat necrosis. All cases complained palpable mass or not was conservatively managed with no other procedure like surgical excision or drainage. But regular follow up was done.


Autologous Fat Graft in the Reconstructed Breast: Fat Absorption Rate and Safety based on Sonographic Identification.

Kim HY, Jung BK, Lew DH, Lee DW - Arch Plast Surg (2014)

Complication after the fat graft(A) A 60-year-old woman, who initially underwent latissimus dorsi myocutaneous flap reconstruction, was noted to have fat necrosis at 38 months after fat graft with 150 mL in the left breast. (B) A 43-year-old woman, who initially underwent implant reconstruction, was noted to have a cyst 13 months after fat graft with 49 mL in the left breast.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4228219&req=5

Figure 3: Complication after the fat graft(A) A 60-year-old woman, who initially underwent latissimus dorsi myocutaneous flap reconstruction, was noted to have fat necrosis at 38 months after fat graft with 150 mL in the left breast. (B) A 43-year-old woman, who initially underwent implant reconstruction, was noted to have a cyst 13 months after fat graft with 49 mL in the left breast.
Mentions: Complications, including fat necrosis and cyst formation, detected by ultrasonograpy of the fat injection site, occurred in 18 of the 102 patients (17.6%) (Table 2, Fig. 3). No infection or implant rupture was noted. Details regarding each complication are provided in Table 2. The presence of a complication was associated with the volume of fat injected. The mean total volume of fat injected into the breasts was 67.5 mL for those patients who developed complications following the procedure, whereas the fat volume was 45.2 mL for those without complications. Of the 18 patients with complications, 10 had fat necrosis, and 8 had cystic lesions. Among them, only three patients complained of a palpable mass, which led to a biopsy; pathologic examination confirmed as fat necrosis. All cases complained palpable mass or not was conservatively managed with no other procedure like surgical excision or drainage. But regular follow up was done.

Bottom Line: However, there remains controversial regarding the efficacy and safety of the practice for reconstructive breast surgery.Calculated fat reabsorption rate was 32.9%.Locoregional recurrence was occurred in 1 patient (0.9%) and the rate was not different significantly with control group (2%).

View Article: PubMed Central - PubMed

Affiliation: Department of Plastic and Reconstructive Surgery, Institute for Human Tissue Restoration, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.

ABSTRACT

Background: Autologous fat graft has become a useful technique for correction of acquired contour deformity in reconstructed breasts. However, there remains controversial regarding the efficacy and safety of the practice for reconstructive breast surgery.

Methods: A retrospective review was performed on 102 patients who had secondary fat grafting after breast reconstruction. Fat harvest, refinement and injection were done by Coleman's technique. All patients were followed up postoperatively within 1 month and after 6 months including physical examination and ultrasonography. In 38 patients, the reabsorption rate was calculated by serial changes of thickness between skin and pectoral fascia in the ultrasonic finding. Locoregional recurrence rate was compared with control group of 449 patients who had breast reconstruction without fat graft in the same time period.

Results: Average 49.3 mL fat was injected into each breast. The most common location of fat graft was upper pole, followed by axilla, lower and medial breasts. During 28.7 months of average follow-up period, 2.9% of total patients had symptoms of palpable mass on fat graft side and ultrasonography identified fat necrosis and cyst formation in 17.6% of the patients. Calculated fat reabsorption rate was 32.9%. Locoregional recurrence was occurred in 1 patient (0.9%) and the rate was not different significantly with control group (2%).

Conclusions: Although further studies are required to provide surgeons with definitive guidelines for the implementation of fat grafting, we propose autologous fat graft is an efficient and safe technique for secondary breast reconstruction.

No MeSH data available.


Related in: MedlinePlus