Fat Grafting in Breast Reconstruction

  • Mario RietjensEmail author
  • Visnu Lohsiriwat
  • Cicero Urban
  • Andrea Manconi


Lipofilling is an autologous technique used in breast reconstruction. It is also known as “fat transfer,” “lipotransfer,” “fat injection,” or “fat transplantation,” as well as many other terminologies. The procedure consists of two major steps which are liposuction and lipoinjection of the patient’s own fat tissue and other tissue elements, either with or without specific preparation processes before lipoinjection. It is considered as a minimally invasive procedure which can be effectively performed under local or general anesthesia.

Supplementary material

Video 54.1

(MP4 163459 kb)

Video 54.2

(MP4 123893 kb)


  1. 1.
    Vallejo A, Urban C, Zucca-Matthes G, Rietjens M (2013) Is there enough evidence to use lipofilling in breast cancer reconstruction? Plast Reconstr Surg 132(4):447–454CrossRefGoogle Scholar
  2. 2.
    Coleman SR (2002) Hand rejuvenation with structural fat grafting. Plast Reconstr Surg 110(7):1731–1744 discussion 45–47PubMedCrossRefGoogle Scholar
  3. 3.
    Coleman SR (2006) Facial augmentation with structural fat grafting. Clin Plast Surg 33(4):567–577PubMedCrossRefGoogle Scholar
  4. 4.
    von Heimburg D, Pallua N (2001) Two-year histological outcome of facial lipofilling. Ann Plast Surg 46(6):644–646CrossRefGoogle Scholar
  5. 5.
    Andre P (2002) Facial lipoatrophy secondary to a new synthetic filler device (Profill) treated by lipofilling. J Cosmet Dermatol 1(2):59–61PubMedCrossRefGoogle Scholar
  6. 6.
    Bertossi D, Zancanaro C, Trevisiol L, Albanese M, Ferrari F, Nocini PF (2003) Lipofilling of the lips: ultrastructural evaluation by transmission electron microscopy of injected adipose tissue. Arch Facial Plast Surg 5(5):392–398PubMedCrossRefGoogle Scholar
  7. 7.
    Gutowski KA (2009) Current applications and safety of autologous fat grafts: a report of the ASPS fat graft task force. Plast Reconstr Surg 124(1):272–280PubMedCrossRefGoogle Scholar
  8. 8.
    Petit JY, Clough K, Sarfati I, Lohsiriwat V, de Lorenzi F, Rietjens M (2010) Lipofilling in breast cancer patients: from surgical technique to oncologic point of view. Plast Reconstr Surg 126(5):262e–263ePubMedCrossRefGoogle Scholar
  9. 9.
    Petit JY, Botteri E, Lohsiriwat V, Rietjens M, De Lorenzi F, Garusi C et al (2012) Locoregional recurrence risk after lipofilling in breast cancer patients. Ann Oncol 23(3):582–588PubMedCrossRefGoogle Scholar
  10. 10.
    Lohsiriwat V, Curigliano G, Rietjens M, Goldhirsch A, Petit JY (2011) Autologous fat transplantation in patients with breast cancer: “silencing” or “fueling” cancer recurrence? Breast 20(4):351–357PubMedCrossRefGoogle Scholar
  11. 11.
    Petit JY, Lohsiriwat V, Clough KB, Sarfati I, Ihrai T, Rietjens M et al (2011) The oncologic outcome and immediate surgical complications of lipofilling in breast cancer patients: a multicenter study-milan-paris-lyon experience of 646 lipofilling procedures. Plast Reconstr Surg 128(2):341–346PubMedCrossRefGoogle Scholar
  12. 12.
    Rietjens M, De Lorenzi F, Rossetto F, Brenelli F, Manconi A, Martella S et al (2011) Safety of fat grafting in secondary breast reconstruction after cancer. J Plast Reconstr Aesthet Surg 64(4):477–483PubMedCrossRefGoogle Scholar
  13. 13.
    Eto H, Suga H, Matsumoto D, Inoue K, Aoi N, Kato H et al (2009) Characterization of structure and cellular components of aspirated and excised adipose tissue. Plast Reconstr Surg 124(4):1087–1097PubMedCrossRefGoogle Scholar
  14. 14.
    Suga H, Matsumoto D, Inoue K, Shigeura T, Eto H, Aoi N et al (2008) Numerical measurement of viable and nonviable adipocytes and other cellular components in aspirated fat tissue. Plast Reconstr Surg 122(1):103–114PubMedCrossRefGoogle Scholar
  15. 15.
    Coleman SR (1995) Long-term survival of fat transplants: controlled demonstrations. Aesthet Plast Surg 19(5):421–425CrossRefGoogle Scholar
  16. 16.
    Sommer B, Sattler G (2000) Current concepts of fat graft survival: histology of aspirated adipose tissue and review of the literature. Dermatol Surg 26(12):1159–1166PubMedCrossRefGoogle Scholar
  17. 17.
    Kaufman MR, Miller TA, Huang C, Roostaeian J, Wasson KL, Ashley RK et al (2007) Autologous fat transfer for facial recontouring: is there science behind the art? Plast Reconstr Surg 119(7):2287–2296PubMedCrossRefGoogle Scholar
  18. 18.
    Gonzalez AM, Lobocki C, Kelly CP, Jackson IT (2007) An alternative method for harvest and processing fat grafts: an in vitro study of cell viability and survival. Plast Reconstr Surg 120(1):285–294PubMedCrossRefGoogle Scholar
  19. 19.
    Erdim M, Tezel E, Numanoglu A, Sav A (2009) The effects of the size of liposuction cannula on adipocyte survival and the optimum temperature for fat graft storage: an experimental study. J Plast Reconstr Aesthet Surg 62(9):1210–1214PubMedCrossRefGoogle Scholar
  20. 20.
    Sasaki GH (2011) Water-assisted liposuction for body contouring and lipoharvesting: safety and efficacy in 41 consecutive patients. Aesthet Surg J 31(1):76–88PubMedCrossRefGoogle Scholar
  21. 21.
    Fraser JK, Zhu M, Wulur I, Alfonso Z (2008) Adipose-derived stem cells. Methods Mol Biol 449:59–67PubMedGoogle Scholar
  22. 22.
    Karacalar A, Orak I, Kaplan S, Yildirim S (2004) No-touch technique for autologous fat harvesting. Aesthet Plast Surg 28(3):158–164CrossRefGoogle Scholar
  23. 23.
    Pulsfort AK, Wolter TP, Pallua N (2011) The effect of centrifugal forces on viability of adipocytes in centrifuged lipoaspirates. Ann Plast Surg 66(3):292–295PubMedCrossRefGoogle Scholar
  24. 24.
    Kim IH, Yang JD, Lee DG, Chung HY, Cho BC (2009) Evaluation of centrifugation technique and effect of epinephrine on fat cell viability in autologous fat injection. Aesthet Surg J 29(1):35–39PubMedCrossRefGoogle Scholar
  25. 25.
    Conde-Green A, Baptista LS, de Amorin NF, de Oliveira ED, da Silva KR, Pedrosa Cda S et al (2010) Effects of centrifugation on cell composition and viability of aspirated adipose tissue processed for transplantation. Aesthet Surg J 30(2):249–255PubMedCrossRefGoogle Scholar
  26. 26.
    Hong SJ, Lee JH, Hong SM, Park CH (2010) Enhancing the viability of fat grafts using new transfer medium containing insulin and beta-fibroblast growth factor in autologous fat transplantation. J Plast Reconstr Aesthet Surg 63(7):1202–1208PubMedCrossRefGoogle Scholar
  27. 27.
    Yoshimura K, Sato K, Aoi N, Kurita M, Hirohi T, Harii K (2008) Cell-assisted lipotransfer for cosmetic breast augmentation: supportive use of adipose-derived stem/stromal cells. Aesthet Plast Surg 32(1):48–55 discussion 6–7CrossRefGoogle Scholar
  28. 28.
    Matsumoto D, Sato K, Gonda K, Takaki Y, Shigeura T, Sato T et al (2006) Cell-assisted lipotransfer: supportive use of human adipose-derived cells for soft tissue augmentation with lipoinjection. Tissue Eng 12(12):3375–3382PubMedCrossRefGoogle Scholar
  29. 29.
    Babovic S (2010) Complete breast reconstruction with autologous fat graft—a case report. J Plast Reconstr Aesthet Surg 63(7):e561–e563PubMedCrossRefGoogle Scholar
  30. 30.
    Biazus JV, Falcão CC, Parizotto AC, Stumpf CC, Cavalheiro JAC, Schuh F, Cericatto R, Zucatto ÂE, Melo MP (2015) Immediate reconstruction with autologous fat transfer following breast-conserving surgery. Breast J 21:268–275. Scholar
  31. 31.
    Alexander Del Vecchio D, Bucky LP (2011) Breast augmentation using pre-expansion and autologous fat transplantation—a clinical radiological study. Plast Reconstr Surg 127:2441–2450CrossRefGoogle Scholar
  32. 32.
    Del Vecchio D (2009) Breast reconstruction for breast asymmetry using recipient site pre-expansion and autologous fat grafting: a case report. Ann Plast Surg 62(5):523–527PubMedCrossRefGoogle Scholar
  33. 33.
    Khouri R, Del Vecchio D (2009) Breast reconstruction and augmentation using pre-expansion and autologous fat transplantation. Clin Plast Surg 36(2):269–280 viiiPubMedCrossRefGoogle Scholar
  34. 34.
    Hamdi M, Andrades P, Thiessen F, Stillaert F, Roche N, Van Landuyt K et al (2010) Is a second free flap still an option in a failed free flap breast reconstruction? Plast Reconstr Surg 126(2):375–384PubMedCrossRefGoogle Scholar
  35. 35.
    Zocchi ML, Zuliani F (2008) Bicompartmental breast lipostructuring. Aesthet Plast Surg 32(2):313–328CrossRefGoogle Scholar
  36. 36.
    Brenelli F, Rietjens M, De Lorenzi F, Pinto-Neto A, Rossetto F, Martella S, Rodrigues JRP, Barbalho D (2014) Oncological safety of autologous fat grafting after breast conservative treatment: a prospective evaluation. Breast J 20:159–165. Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2019

Authors and Affiliations

  • Mario Rietjens
    • 1
    Email author
  • Visnu Lohsiriwat
    • 2
  • Cicero Urban
    • 3
  • Andrea Manconi
    • 4
  1. 1.Division of Plastic and Reconstructive SurgeryEuropean Instituteof OncologyMilanItaly
  2. 2.Plastic and Reconstructive DepartmentEuropean Institute of Oncology—IEOMilanItaly
  3. 3.Department of Surgery, Siriraj HospitalMahidol University Medical SchoolBangkokThailand
  4. 4.Breast UnitOur Lady of Grace Hospital and Positivo University Medical SchoolCuritibaBrazil

Personalised recommendations