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Total Breast Reconstruction Using Autologous Fat Grafting Following Nipple-Sparing Mastectomy in Irradiated and Non-irradiated Patients

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Abstract

Background

Although autologous microvascular reconstruction following nipple-sparing mastectomy (NSM) is considered one of the best reconstructive choices, this procedure cannot be offered to all patients. The aim of this study was to define a fat grafting protocol for successful reconstruction following NSM and to assess its reliability in irradiated and non-irradiated patients.

Materials and Methods

Twenty-one patients were prospectively enrolled and stratified in Group-A (11 non-irradiated) and Group-B (10 irradiated) NSMs comparing clinical and aesthetic outcomes. A fat grafting protocol was used to standardize the procedure. Continuous and categorical variables were analysed using the Student t test and the Kruskal–Wallis test, respectively. A value of p ≤ 0.05 was considered statistically significant.

Results

The groups were homogeneous in terms of demographics (p > 0.05), while number of sessions, mean volume of the first two treatments, and overall injected volume showed significant differences (p < 0.001; p < 0.001; p = 0.002). Volume, shape, position of the breast mound, IMF and scar location subscales obtained high score evaluations without a significant difference between the groups (p > 0.05), whereas the skin texture subscale showed a lower score evaluation in Group-B than in Group-A (p = 0.001). Although a significant difference for total subscales was in favour of Group-A (p = 0.001), the global score had a high rate evaluation in both groups (p = 0.132). Inter-rater reliability showed substantial agreement among all categories, total and global scores.

Conclusions

To the best of our knowledge, this is the first prospective series of fat transfer reconstructions following NSM using a systematic approach. Although further studies are required, it may be considered an effective option whenever flap reconstruction cannot be performed.

Level of Evidence III

This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.

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Conflict of interest

The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Plastic Surgery Department, Sant’Andrea Hospital, School of Medicine and Psychology, “Sapienza” University of Rome, Via di Grottarossa 1035-1039, 00189, Rome, Italy

    Benedetto Longo, Rosaria Laporta, Michail Sorotos, Marco Pagnoni, Marika Gentilucci & Fabio Santanelli di Pompeo

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  1. Benedetto Longo
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  2. Rosaria Laporta
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  3. Michail Sorotos
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  4. Marco Pagnoni
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  5. Marika Gentilucci
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  6. Fabio Santanelli di Pompeo
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Correspondence to Fabio Santanelli di Pompeo.

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Longo, B., Laporta, R., Sorotos, M. et al. Total Breast Reconstruction Using Autologous Fat Grafting Following Nipple-Sparing Mastectomy in Irradiated and Non-irradiated Patients. Aesth Plast Surg 38, 1101–1108 (2014). https://doi.org/10.1007/s00266-014-0406-3

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  • DOI: https://doi.org/10.1007/s00266-014-0406-3

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