Efficacy of breast reconstruction with fat grafting: A systematic review and meta-analysis

Herly, Mikkel; Ørholt, Mathias; Larsen, Andreas; Pipper, Christian Bressen; Bredgaard, Rikke; Gramkow, Christina; Katz, Adam J.; Drzewiecki, Krzysztof T.; Vester-Glowinski, Peter

doi:10.1016/j.bjps.2018.08.024

Cited by 56 publications

(35 citation statements)

References 36 publications

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“…In a recent meta-analysis of 21 studies analyzing 1,011 breast reconstructions in 834 patients, 2.84–4.66 sessions were required to complete reconstruction. 11 …”

Section: Introductionmentioning

confidence: 99%

Breast Reconstruction Combining Lipofilling and Prepectoral Prosthesis after Radiotherapy

Razzouk

Fitoussi²,

Khori

et al. 2020

Plastic and Reconstructive Surgery - Global Open

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Background: Prosthetic reconstruction in previously irradiated breasts has been associated with a higher risk of complications. Here we describe the surgical and cosmetic outcome of our breast reconstruction process based on primary fat grafting combined with prosthetic placement. Methods: In this multicenter retrospective study, 136 patients who underwent mastectomy and external chest wall radiotherapy between 2014 and 2018 were benefited from chest wall lipofilling and silicone implant placement were chosen. Patients were assessed for skin trophicity, thickness, and mobility and were allowed to undergo several lipofilling sessions before implant placement, if required. No patient had >3 lipofilling sessions. Cosmetic outcome was evaluated by the patient, surgeon, and nurse, using a Likert-type ordinal scale. Results: We included 136 patients: 79 patients (58%) received only 1 session of lipofilling before implant placement, 33 (24.6%) had 2 sessions, and 24 (17.4%) had 3 sessions. The volume of the third lipofilling was significantly higher and the volume of the prosthesis of these patients was significantly lower than those of patients undergoing 1 or 2 lipofillings. Reconstruction failure rate was 2.2% (3 patients had explantation); however, all benefited from prosthesis reconstruction a year after the initial procedures. The average satisfaction score was 4.7 out of 5 as evaluated by patients, 4.8 out of 5 by surgeons, and 4.8 out of 5 by nurses. Conclusions: Primary lipofilling combined with prosthesis placement after radiotherapy is a reconstructive method that yields a satisfactory cosmetic outcome with a low complication rate. Such minimally invasive breast reconstruction approach can be an alternative to flap-based reconstruction.

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“…In a recent meta-analysis of 21 studies analyzing 1,011 breast reconstructions in 834 patients, 2.84–4.66 sessions were required to complete reconstruction. 11 …”

Section: Introductionmentioning

confidence: 99%

Breast Reconstruction Combining Lipofilling and Prepectoral Prosthesis after Radiotherapy

Razzouk

Fitoussi²,

Khori

et al. 2020

Plastic and Reconstructive Surgery - Global Open

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“…Therefore, the efficiency of fat grafts during breast reconstruction was important. Although radiotherapy is the most important factor associated with the number of treatment sessions according to a metaanalysis [33]. Limited layer for transplantation was an obvious obstacle even muscular and submuscular layers were considered as target layers [34].…”

Section: Discussionmentioning

confidence: 99%

Introduction of ligated vessels promote the retention and regeneration of free fat: constructing a fat flap in tissue engineering chamber

et al. 2020

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Background: Breast reconstruction with fat grafting has an unstable retention rate due to insufficient revascularization. Tissue Engineering Chamber (TEC) model can promote tissue regeneration in the chamber by introducing ligated vessels around the tissue. We introduced ligated vessels with free fat graft to investigate the retention rate and revascularization of grafted fat that in TEC model. Methods: SD rats (n=24) was divided into 3 groups randomly. Group A: Standard TEC model was constructed; Group B: the epigastric vessel bundles were dissected from the fat flap and ligated, fat flap was cut into granules and planted into the chamber; Group C: Free fat was planted in the chamber. At week 6, samples in the chamber were harvested. Results: Significant volume increase was observed in group A and B, while the volume decreased in group C (P<0.05). Regeneration morphology could be found according to the histological observation in A and B. Micro CT results showed the ligated vessels into grafted fat sprouting robustly, coordinated with volume changes. Conclusion: Fat grafts in TEC model could not only survive but also regenerate. The combination of fat graft and TEC could fabricate a vascularized fat flap, which was a promising method in breast reconstruction.

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“…14 Due to increased fibrosis and decreased compliance of the recipient sites in irradiated breasts, these patients require an increased number fat grafting sessions. 14,15 In patients without irradiated breasts, increased volume does not increase the recipient site's capacity even with maximum compliance. 12 Therefore, surgeons seeking to overcorrect greater than 10% with larger volumes of fat grafts will have higher rate of oil cysts and subsequent calcifications.…”

Section: Complicationsmentioning

confidence: 99%

“…[8][9][10][11] Refinement of techniques and establishment of clear standards for the process of fat grafting to the breast have allowed surgeons to successfully use fat grafting for various applications. [12][13][14] The use of fat grafting can result in a breast with both a natural appearance and a supple feel, and the technique continues to gain popularity as a reconstructive option for eligible patients. 12 Autologous fat grafting offers tremendous versatility in its extensive potential applications in breast reconstruction.…”

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confidence: 99%

Fat Grafting in Breast Reconstruction

Turner

Abu‐Ghname

Davis

et al. 2020

Seminars in Plastic Surgery

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The past two decades have witnessed a growing application of autologous fat grafting in the setting of breast reconstruction after surgical treatment of breast cancer. While traditionally used to correct contour deformities during secondary revisions, fat grafting has since evolved to achieve desired breast shape and size both as a complementary adjunct to established reconstructive techniques as well as a standalone technique for whole breast reconstruction. In this article, we will review fat grafting as an adjunct to autologous and implant-breast based reconstruction, an option for primary breast reconstruction, and a treatment of postmastectomy pain.

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Efficacy of breast reconstruction with fat grafting: A systematic review and meta-analysis

Cited by 56 publications

References 36 publications

Breast Reconstruction Combining Lipofilling and Prepectoral Prosthesis after Radiotherapy

Breast Reconstruction Combining Lipofilling and Prepectoral Prosthesis after Radiotherapy

Introduction of ligated vessels promote the retention and regeneration of free fat: constructing a fat flap in tissue engineering chamber

Fat Grafting in Breast Reconstruction

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