Lipofilling is fat grafting to the breast. This was a study in September 2023 issue of Plastic and Reconstructive Surgery Journal out of Finland. “Total Breast Reconstruction with Lipofilling after Traditional Mastectomy without the Use of Tissue Expanders.”
They looked at patients who completed breast reconstruction with lipofilling alone. MRI scans were used when possible, to look at volume retention and quality of transferred fat. Patients were asked to look at the appearance and sensitivity of the reconstructed breast, the recovery time, and any issues with the fat donor area.
Results?
- 38 women were in the study.
- Median age 62
- Most had 4 surgeries to fat graft. (range was 2-6)
- Follow up was at 2 years on average
- Average amount grafted was 690 cc total, with 58% of the fat on average being retained.
- They were able to make the breast 76% of the contralateral side.
- Biggest issues: Oil cysts, seen in 41%. 12% had a mass, that needed a needle biopsy. Benign calcifications were seen in 24%.
- Most patients were satisfied.
What is important about this study?
They were able to bring science to the table to analyze the fat transferred amount, how much was retained, and what it looked like on MRI.
I think when doing fat grafting for breast cancer, it is important to look at the number of surgeries. This is NOT a one and done surgery. This is a series of surgeries, which varies in number. When I did my training with Dr. Khouri in Miami, you can see how the first surgeries are just to “get your foot in the door.” As the tissue loosens and expands, you can graft more in subsequent surgeries.
They used the water jet assisted liposuction technique, where the aspirate was drawn into 50cc syringes and held upright to decant. 10cc syringes were used to inject the fat. They did injections into the muscle, under the fat, and under the skin to try to create a 3D framework of fat.
They did not do any skin expansion. No Brava domes. No tissue expanders. They cite a recent study showing no difference for radiated or non irradiated breasts with the number of lipofilling procedures required or the volume of fat transferred per session.
The patients seemed to like it. The breast sensation was 8/10 compared to the normal breast. Ease of recovery was 9/10. They reported little or no pain, bruising, or contour irregularities at the fat donor area after 2 months post-surgery.
They conclude that fat grafting to the breast for cancer surgery is a “good alternative for those who cannot do more complex reconstructive surgery options.”
I think it is great. Free liposuction? Breast reconstruction without an implant? It’s great. It just takes multiple procedures.