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Fat graft survival is comparable regardless of breast reconstruction method
Kevin H. Small, MD, Nolan Karp, MD, Christina Lee, BA, Chaya Levovitz, BA, Mihye Choi, MD.
New York University School of Medicine, NYC, NY, USA.
Background: Secondary refinements for the reconstructed breast are routine procedures as plastic surgeons continue to desire more natural results. Autologous fat grafting (FG) has become an important option for correcting contour irregularities and volume deficiencies. Previous short-term studies have reported about fifty percent volume retention at 50 days after FG to the breast but have not answered whether the type of reconstruction affects retention outcomes. The following study applies 3D imaging to assess the stability of the breast following secondary FG in various recipient sites: implant breast reconstruction, breast lumpectomy defects, and autologous breast reconstruction.
Methods: All patients receiving FG to the reconstructed breast from 2009-2010 were enrolled in the study. FG surgery was performed using a modified Coleman technique. Preoperative and post-operative 3D scans at three months were obtained on all patients. 3D imaging was performed using the Canfield VECTRA system and analyzed using Geomagic software. As previously described, breasts were isolated as closed objects and total breast volume was calculated on every scan.
Results: In the observed time period, total 116 patients underwent fat grafting for secondary breast reconstruction. 62 implant breast reconstruction patients, 14 breast lumpectomy patients, and 40 autologous breast reconstruction patients received autologous fat transfer and were studied by 3D images pre and postoperatively. Average fat injected to the breast was 100cc. At 3 months postoperatively, all breasts averaged 42% volume retention and 0.48%/day resorption rate. The implant subset had 42% volume retention and resorption rate of 0.41%/day. For the lumpectomy subset, the breast had 42% volume retention and resorption rate of 0.45%/day. For the autologous subset, the breast had 44% volume retention and resorption rate of 0.55%/day. No statistical difference was found between the three groups.
Conclusion: FG for secondary breast reconstruction is an essential tool to refine breast shape and volume. Our data suggests that breast reconstruction type does not affect percent volume retention and resorption rate. Long-term studies are needed to confirm the stability of the breast.
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