Simultaneous Fat Grafting During Tissue Expander-to-Implant Exchange: A Propensity Score-Matched Analysis

Escandón, Joseph M.; Ali-Khan, Safi; Christiano, Jose G.; Gooch, Jessica C.; Olzinski, Ann Therese; Prieto, Peter A.; Langstein, Howard N.; Manrique, Oscar J.

doi:10.1007/s00266-022-03152-7

Cited by 9 publications

(12 citation statements)

References 15 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Because of the high vascularity of LD flaps [58] , they are well suited for adjunct fat grafting to improve the resulting appearance and symmetry [9,49,59,60] . Volumes reported in several studies ranged between 90.5-425 mL [51,56,61,62] .…”

Section: Ld Flapsmentioning

confidence: 99%

“…Recently, fat grafting has been used independently for primary augmentation, total breast reconstruction, and post-implant replacement, making it an increasingly accepted alternative to the more invasive approaches, especially in small to moderate-volume breasts [47,[71][72][73] . Despite the aforementioned fat grafting drawbacks, using autologous tissue may be preferable to prosthetics for many patients as it does not have implant-related risks and gives a more natural look and feel in comparison [13,46,47,60,[74][75][76] . High satisfaction rates have been described by Dayal, Bhatia, and Hsu, with over 86.5% of patients reported to have either good or very good results judged by an independent panel of surgeons with a mean follow-up of 12 months [47] .…”

Section: Total Autologous Breast Reconstructionmentioning

confidence: 99%

“…Total breast reconstruction with fat grafting is recommended for women requiring small to moderate volume augmentation, such as breast-conserving mastectomy (lumpectomy) to fill contour defects [9,46,48,60] . It is also recommended to minimize significant asymmetry and to improve cleavage appearance by adjusting intermammary distance [9] .…”

Section: Total Autologous Breast Reconstructionmentioning

confidence: 99%

“…Activities such as movement, straining, overhead activity, and cold weather can exacerbate symptoms and cause further disability, reduced quality of life, and emotional distress. Jung et al classified PMPS into four categories; phantom breast pain, intercostobrachial neuralgia stemming from intercostobrachial nerve damage, neuroma pain, and other nerve injury pain from surrounding nerves' damage [60,106,107] .…”

Section: Fat Grafting For Pain Reductionmentioning

confidence: 99%

“…The current leading hypotheses on PMPS etiology include intraoperative nerve damage to any of the primary nerves affected during mastectomy or breast surgeries in general, i.e., the intercostobrachial, medial and lateral pectoral, thoracodorsal, long thoracic, and intercostal nerves [108,109] , and subsequent entrapment in cicatricial fibrosis, which may incite continuous nervous excitement. Additional hypotheses include decreased circulation, scarring/fibrosis, and injury to fibroblasts after radiation [60,106,110] .…”

Section: Fat Grafting For Pain Reductionmentioning

confidence: 99%

See 4 more Smart Citations

Fat grafting in autologous breast reconstruction: applications, outcomes, safety, and complications

Shaaban¹,

Gourichon²,

Cruz³

et al. 2023

Plast Aesthet Res

View full text Add to dashboard Cite

Autologous fat grafting is an important surgical technique in aesthetic and reconstructive procedures. Fat grafting for breast reconstruction is now an established procedure for adding volume and improving cutaneous pliability; it can be used independently to replace more invasive flap procedures or implants, or as an adjunct for smaller volume supplementation. The breadth of applications in the breast necessitates diversity in technique and approach, and while there is no universally agreed-upon protocol, basic principles have guided the evolution of some commonly adopted tenets. Broadly, fat grafting outcomes are highly favorable but dependent on patient and procedure factors, requiring learned patient selection and expertise in recipient site assessment. Common complications from fat grafting, such as fat necrosis and the development of nodules, are particularly troublesome for post-oncologic patients, requiring considerable pre-surgical consultation for patient education and managing expectations. In addition to volume and contour augmentation, fat grafting has additional beneficial effects that have recently drawn increased attention including pain reduction from implant capsular contracture or post-mastectomy pain syndrome, improved skin quality and reduced fibrosis following radiation, and possible anti-tumorigenic effects. New developments in clinical fat grafting research that are promising include the use of adipose progenitor cells admixed with lipoaspirate for improved volume retention or alternative biologics such as platelet-rich plasma. Preclinically, research towards safe and effective regenerative medicine approaches is actively underway, with the ultimate goal of achieving predictable and increased graft retention, reducing the number of required surgical procedures and enabling on-table results to reflect procedure outcomes.

show abstract