Lipomodeling for Breast-Conservative Treatment Sequelae

Abstract

Sequelae of conservative treatment and radiotherapy of breast cancer are real challenges for the surgeon. Few years after treatment of their cancer, patients are very eager for surgical correction of their deformity to erase or attenuate the visible signs of their disease. Musculocutaneous latissimus dorsi flaps were often used to correct the sequelae, but quite disproportionate to the breast deformity. Improvement of fat grafting technique and early result of fat transfer for breast after reconstruction led us to a solution that would correct these sequelae and help these patients to regain better self-esteem and to reintegrate their breast in their body image. This chapter presents the information that should be given to the patients and the precautions that should be taken before carrying out this procedure, the surgical technique, the results that may be expected, and the advantages and drawbacks of the technique, which is simple but requires a learning curve to avoid fat necrosis. No surgical implant or flap reconstruction is necessary. There is normal fat wasting within the first months after treatment, and then results stabilize as the patient maintains a healthy weight. Several procedures may be needed as sever is the deformity. A radiologic follow-up is needed before and after the procedure to be sure that there is no potential recurrence. In conclusion, the fat transfer approach represents a considerable advance for the management of moderate sequelae of conservative breast treatment. Using this technique makes it possible to restore the shape and softness of the breast better than any other surgical procedure before, particularly for patients with mild breast deformity.