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Treating Pain and Fat Necrosis after Breast Cancer Surgery with Fat Grafting: Is one Session Enough?

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  • Breast Surgery
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Abstract

Background

Chronic pain after breast cancer surgery is affecting up to 60% of patients, causing significant morbidity to patients. Lately, fat grafting has been applied as a therapy for chronic neuropathic pain.

Methods

We report a series of eighteen patients, who were treated for pain after breast cancer surgery. Twelve patients had a breast conserving therapy, two a mastectomy and four an autologous flap-based reconstruction. While most presented with neuropathic pain, six patients had fat necrosis in their history. Most patients presented with severe pain (77%) and were treated with fat grafting sessions, performed by water-assisted liposuction.

Results

All patients responded to the interventions; the median number of fat grafting sessions was 2, the median duration of the interventions was 4 months, and the median follow-up period was 56.5 months. The median pain prior to the fat grafting procedure had an intensity of 8 (range 7–9) numeric rating scale points; after the first intervention, this was reduced to 4 (range 2.3–5.8); and after the second intervention, it was down to 2 (range 0.8–3.3). Patients with pain intensities of 4–5 had a good chance of achieving analgesia after one session.

Conclusions

Fat grafting could be a new treatment modality for symptomatic fat necrosis: complete or partial suction of the necrosis and/or fat grafting around the necrosis to reduce inflammation and pain. Fat grafting proved a valuable tool, reducing pain or even achieving analgesia after breast cancer surgery presenting with a highly favorable risk–benefit ratio.

Level of Evidence IV

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Author information

Authors and Affiliations

  1. Department of Senology, Evangelische Kliniken Gelsenkirchen, Munckelstrasse 27, 45879, Gelsenkirchen, Germany

    Sarantos Papadopoulos, Goran Vidovic & Abdallah Abdallah

  2. Senology Practice, Vasillisis Sofias Avenue 115, 11521, Athens, Greece

    Sarantos Papadopoulos

  3. Plastic Surgery Department, AZ Monica Hospitals, Antwerp, Belgium

    Steven D. M. Colpaert

  4. Department of Obstetrics and Gynecology, Breast Center, Muenster University, Muenster, Germany

    Joke Tio

  5. 1st Department of Obstetrics and Gynecology, Medical School, Aristotle University Thessaloniki, Thessaloniki, Greece

    Grigorios F. Grimbizis

Authors
  1. Sarantos Papadopoulos
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  2. Steven D. M. Colpaert
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  4. Goran Vidovic
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  6. Abdallah Abdallah
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Correspondence to Sarantos Papadopoulos.

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The authors have no conflicts of interest to disclose.

Ethical approval

This study was conducted following the principles expressed in the Declaration of Helsinki update of 2008. Each patient provided written informed consent both for the surgical procedures and to participate in this retrospective study.

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Papadopoulos, S., Colpaert, S.D.M., Tio, J. et al. Treating Pain and Fat Necrosis after Breast Cancer Surgery with Fat Grafting: Is one Session Enough?. Aesth Plast Surg 46, 2677–2688 (2022). https://doi.org/10.1007/s00266-022-02983-8

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