Autologous Fat Grafting for Whole Breast Reconstruction

Abstract

Summary:This is the first reported case of a patient who had a single-stage large-volume breast reconstruction with autologous fat grafting, following rotation flap approach (RoFA) mastectomy. The purpose of this case study was to evaluate the viability of reconstruction of the breast by autologous fat grafting alone, in the context of RoFA mastectomy. The hypothesis was that there would be minimal interval loss of autologous fat on the whole breast reconstruction side. Right RoFA mastectomy was used for resection of an invasive primary breast cancer and resulted in the right breast skin envelope. Eleven months later, the patient underwent grafting of 400 ml of autologous fat into the skin envelope and underlying pectoralis major muscle. Outcome was assessed by using a validated 3D laser scan technique for quantitative breast volume measurement. Other outcome measures included the BREAST-Q questionnaire and 2D clinical photography. At 12-month follow-up, the patient was observed to have maintenance of volume of the reconstructed breast. Her BREAST-Q scores were markedly improved compared with before fat grafting, and there was observable improvement in shape, contour, and symmetry on 2D clinical photography. The 2 new techniques, RoFA mastectomy and large-volume single-stage autologous fat grafting, were used in combination to achieve a satisfactory postmastectomy breast reconstruction. Novel tools for measurement of outcome were the 3D whole-body laser scanner and BREAST-Q questionnaire. This case demonstrates the potential for the use of fat grafting for reconstruction. Outcomes in a larger patient populations are needed to confirm these findings.

The compressed breast during mammography and breast tomosynthesis:in vivoshape characterization and modeling

“…This imaging technique allows, for the first time, to accurately characterize the breast under compression. In addition to obtaining information for breast modeling, this methodology could be used during mammography or breast tomosynthesis acquisition for improved image processing and/or reconstruction, as well as other clinical tasks, such as breast volumetric estimation and registration (Chae et al, 2016; Fradkin et al, 2013; Howes et al, 2014), 3D printing of realistic phantoms, and aiding in the planning of breast surgery.…”

Long-term clinical results and quality of life in patients undergoing autologous fat transplantation for breast augmentation using the BEAULI™ protocol

“…The advantage of BEAULI™ protocol is that the procedure is gentle on the fat cells. The patients and the doctors feel satisfaction with the lipotransfer [ 11 ], [ 13 ], [ 14 ], [ 21 ], including for reconstruction of the breast following mastectomy [ 15 ], [ 21 ], [ 22 ], [ 23 ]. Most of the studies regarding quality of life after breast enlargement have surveyed patients before and shortly after the operation [ 24 ], [ 25 ], [ 26 ], but not after several years.…”

Review of three-dimensional (3D) surface imaging for oncoplastic, reconstructive and aesthetic breast surgery

“…One case report [89] used 3D-SI to document the volume changes over time. Another study [90] successfully imaged seven patients to assess fat retention demonstrating one third fat retention.…”