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Fat Grafting For Total Autologous Breast Reconstruction: A Retrospective Cohort Study
Walter J. Joseph, III MD, J. Peter Rubin MD, Sydney Coleman MD, Carolyn De La Cruz MD
UPMC
2019-02-15
Presenter: Walter J. Joseph, III MD
Affidavit:
Vu T. Nguyen
Director Name: Vu T. Nguyen
Author Category: Resident Plastic Surgery
Presentation Category: Clinical
Abstract Category: Breast (Aesthetic and Recon.)
PURPOSE: Fat grafting (FG) has emerged as an oncologically safe and irreplaceable technique in breast reconstruction. There is a paucity of literature examining FG for total autologous breast reconstruction (TBAR), particularly analyzing the procedures and time involved. Here, we report a single surgeon's experience using FG entirely for TABR.
METHODS: Retrospective cohort review was performed of patients who underwent TABR with FG by a single senior surgeon (CD) between 2013-2018.
RESULTS: 12 female patients were identified. Number of FG procedures ranged from 1-5 and averaged 3.08+/-1.50. BMI and number of procedures was inversely correlated with R = -0.24 and R2= 0.061. As expected, the initial round of FG was on average the lowest volume (189.67+/-92.99 cc). The abdomen was the donor site of choice for first-round FG (75% of patients), while the lower extremities were the donor sites in 33.33% of patients. For subsequent rounds of FG procedures, the abdominal donor site became less common and the lower body more common. Donor site contour irregularities requiring surgical correction were present in 16.67% of patients. FG volumes in subsequent procedures did not differ significantly (P>0.05).
CONCLUSION: We show that lower BMI was correlated with more FG procedures, likely due to a more diminutive donor site and overall lower graft volumes. Graft volume stayed relatively consistent among subsequent procedures, with the abdomen as the most common initial donor site and the lower extremities in later procedures. Future studies will aim to further elucidate graft 'take' through 3D image analysis.
