Outcomes of Prosthetic Reconstruction of Irradiated and Nonirradiated Breasts with Fat Grafting
Komorowska-Timek E, Turfe Z, and Davis AT. Outcomes of prosthetic reconstruction of irradiated and nonirradiated breasts with fat grafting Plast Reconstr Surg 2017; 139(1):1e-9e.
Plastic and reconstructive surgery
BACKGROUND: Fat grafting may be beneficial in prosthetic reconstruction of irradiated tissues, but there is a paucity of data on the complication rates associated with this clinical scenario.
METHODS: All consecutive patients who had undergone fat grafting and prosthetic reconstruction from 2010 to 2013 were enrolled. Variables obtained related to fat grafting and history of irradiation. Implant-related complications in relation to irradiation status were also noted.
RESULTS: Eighty-five patients (age 49 ± 10 years) underwent 117 fat grafting procedures. The mean follow-up was 2.6 ± 0.7 years. Fat grafting was predominantly performed to correct soft-tissue deficiency [112 of 117 (95.7 percent)] or to alter skin after irradiation [five of 117 (4.3 percent)]. Thirty-two procedures (27.4 percent) were associated with a complication, with the most common being palpable fat necrosis (23.1 percent). Volume of transferred fat averaged 151.2 ± 76.6 ml per breast. Fat grafting complications did not depend on donor site, technique of fat processing, volume of transferred fat, number of procedures, or irradiation. Implant-related complications were observed after 26 of 117 overall procedures (22.2 percent). No association between implant-related complications and irradiation was observed (OR, 1.3; 95 percent CI, 0.4 to 4.1; p = 0.63). Overall complications following fat grafting in nonirradiated [37 of 82 (45.1 percent)] and irradiated [16 of 35 (45.7 percent)] breasts were not statistically different (OR, 1.02; 95 percent CI, 0.41 to 2.57; p = 0.96).
CONCLUSION: Similar outcomes of irradiated and nonirradiated prosthetic breast reconstruction can be achieved with additional fat grafting.
CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, III.
Medical Subject Headings
Adult; Aged; Breast Implantation; Breast Neoplasms; Carcinoma, Ductal, Breast; Carcinoma, Intraductal, Noninfiltrating; Carcinoma, Lobular; Female; Follow-Up Studies; Humans; Logistic Models; Mastectomy; Middle Aged; Phyllodes Tumor; Postoperative Complications; Radiotherapy, Adjuvant; Retrospective Studies; Subcutaneous Fat; Treatment Outcome