Abstract: Outcomes of Autologous Fat Grafting Following Breast Reconstruction in Post-Mastectomy Patients (Plastic Surgery 2014)

Sunday, October 12, 2014: 11:30 AM

Christodoulos Kaoutzanis, MD , Surgery, Saint Joseph Mercy Health System, Ann Arbor, MI

Minqiang Xin, MD , Plastic Surgery, University of Michigan, Ann Arbor, MI

Tiffany N.S. Ballard, MD , Plastic Surgery, University of Michigan, Ann Arbor, MI

Adeyiza O. Momoh, MD , Plastic Surgery, University of Michigan, Ann Arbor, MI

Jeffrey Kozlow, MD , Plastic Surgery, University of Michigan, Ann Arbor, MI

David L. Brown, MD , Plastic Surgery, University of Michigan, Ann Arbor, MI

Paul S. Cederna, MD , Plastic Surgery, University of Michigan, Ann Arbor, MI

Edwin G. Wilkins, MD, MS , Plastic Surgery, University of Michigan, Ann Arbor, MI

Presentation PDF file

Background:Autologous fat grafting has become a widely used adjunct for refinement of both implant-based and autologous tissue breast reconstruction. However, there are only a few studies evaluating the results of autologous fat grafting in this patient population. The purpose of this study was to assess complication rates and other outcomes of autologous fat grafting following post-mastectomy breast reconstruction.

Methods:We retrospectively reviewed the medical records of consecutive post-mastectomy patients who underwent autologous fat grafting after breast reconstruction at a university center over a 5 year period with at least 6 months of follow-up. We reviewed patient demographics; mastectomy and reconstructive operative details; autologous fat grafting information including local and distant/systemic complications; imaging and biopsy rates; and locoregional cancer recurrence rates. Descriptive statistics were generated for these outcomes.

Results:Between January 2008 and July 2013 108 women underwent autologous fat grafting for contouring following breast reconstruction. Their ages ranged from 22 to 71 years (mean 48.3 years). Fourty-eight (44.4%) patients underwent unilateral mastectomy, whereas 60 (55.6%) had bilateral mastectomies. For unilateral mastectomy patients, 24 (50%) underwent implant-based reconstruction and 24 (50%) received autologous tissue reconstruction. Among patients with bilateral mastectomies, 15 (25%) underwent implant-based reconstruction, 32 (53.3%) received autologous tissue reconstruction, and 13 (21.7%) underwent combinations of these approaches. Fat grafts were harvested and processed using the Coleman technique¹. The volume of fat grafted varied from 15cc to 180cc (mean 54.7cc). Follow up ranged from 6.3 to 57.4 months (mean 16.8 months). Thirty-eight (35.2%) women underwent imaging following autologous fat grafting. Imaging was unremarkable in 17 (15.7%) patients, and non-suspicious imaging lesions were identified in 13 (12%) patients. Suspicious imaging lesions were discovered in 4 (3.7%) patients, and clinically palpable lesions were also detected in 4 (3.7%) patients. All 8 patients underwent biopsies (4 core and 4 excisional),all showing only fat necrosis. One (0.9%) local complication, a wound infection requiring oral antibiotics, was reported. There were no systemic complications. During this limited follow up period, no study patients had locoregional cancer recurrence.

Conclusions:Autologous fat grafting in conjunction with breast reconstruction resulted in a biopsy rate of 7.4%, with no cases of locoregional recurrence observed. Based on these preliminary findings, autologous fat grafting appears to be a relatively safe procedure for refinement of the reconstructed breast in post-mastectomy patients.

24921 Outcomes of Autologous Fat Grafting Following Breast Reconstruction in Post-Mastectomy Patients