For women undergoing breast cancer surgery, a technique called lipofilling—using the patient's own fat cells to optimize the results of breast reconstruction—does not increase the risk of recurrent breast cancer, reports a study in the February issue of Plastic and Reconstructive Surgery®, the official medical journal of the American Society of Plastic Surgeons (ASPS).

"Our controlled study shows that, used as part of breast reconstruction, lipofilling is a safe procedure that does not increase the risk of recurrent or new breast cancers," comments ASPS member surgeon Dr. Steven J. Kronowitz of Kronowitz Plastic Surgery, Houston (formerly of M.D. Anderson Cancer Center), lead author of the new report.

New Evidence That Lipofilling Is Safe for Breast Reconstruction

Using a plastic surgery database, the researchers analyzed a series of more than 1,000 partial or total mastectomies followed by breast reconstruction with lipofilling. About 30 percent of cases involved risk-reducing mastectomy in women at high genetic risk of breast cancer.

Rates of recurrent or new breast cancers were then compared with a similar group of women who underwent mastectomy followed by breast reconstruction without lipofilling. In the lipofilling procedure, fat obtained by liposuction from one part of the body—for example, the abdomen or thighs—is injected to enhance the appearance of the breast.

For women who underwent mastectomy for breast cancer, overall recurrence rates were similar for reconstruction with versus without lipofilling. The rate of locoregional recurrence (in the breast and surrounding area) was not significantly different between groups: 1.3 percent for women who had lipofilling versus 2.4 percent in those who did not.

Rates of systemic (distant) cancer recurrence were similar as well: 2.4 percent with lipofilling versus 3.6 percent without. None of the women undergoing preventive mastectomy developed initial (primary) breast cancer.

In most patient subgroups, breast cancer recurrence risk was similar with or without lipofilling. The sole exception was women receiving hormone therapy, for whom lipofilling was associated with a small but significant increase in locoregional recurrence risk: 1.4 versus 0.5 percent.

Lipofilling is a fat grafting technique that is increasingly used to optimize the cosmetic results of breast reconstruction. In a 2013 survey, more than 60 percent of ASPS member surgeons said they used fat grafting as part of breast reconstruction.

ut some plastic surgeons may still be reluctant to use lipofilling because of concern that it might affect the risk of primary or recurrent breast cancer. The new study of breast cancer recurrence risk associated with lipofilling is the first to use a control group of women who underwent breast reconstruction without lipofilling.

The results show no increase in the risk of locoregional or systemic recurrence in women with breast cancer who undergo breast reconstruction with lipofilling. The study also finds no evidence that lipofilling affects the risk of initial breast cancer for the growing number of high-risk womenundergoing "preventive" mastectomy.

"Our results provide new evidence that lipofilling, used as part of breast reconstruction, is a safe procedure that does not increase the risk of recurrent or new breast cancer after mastectomy," Dr. Kronowitz comments. While highlighting the need for further research, the researchers hope their findings will encourage more plastic surgeons to use lipofilling to provide the best possible results of breast reconstruction for their patients undergoing breast cancer surgery.

Plastic and Reconstructive Surgery® is published by Wolters Kluwer.

About PRS Global Open

Plastic and Reconstructive Surgery—Global Open (PRS Global Open) is an open access, rigorously peer-reviewed, international journal focusing on global plastic and reconstructive surgery. PRS Global Open educates and supports plastic surgeons globally to provide the highest quality patient care and maintain professional and ethical standards through education, research, and advocacy.

About Wolters Kluwer Health

Wolters Kluwer Health is a leading global provider of information, business intelligence and point-of-care solutions for the healthcare industry. Serving more than 150 countries and territories worldwide, Wolters Kluwer Health’s customers include professionals, institutions and students in medicine, nursing, allied health and pharmacy. Major brands include Health Language®, Lexicomp®, Lippincott Williams & Wilkins, Medicom®, Medknow, Ovid®, Pharmacy OneSource®, ProVation® Medical and UpToDate®.

Wolters Kluwer Health is part of Wolters Kluwer, a market-leading global information services company. Wolters Kluwer had 2012 annual revenues of €3.6 billion ($4.6 billion), employs approximately 19,000 people worldwide, and maintains operations in over 40 countries across Europe, North America, Asia Pacific and Latin America. Follow our official Twitter handle: @WKHealth.

About ASPS

The American Society of Plastic Surgeons (ASPS) is the world's largest organization of board-certified plastic surgeons. Representing more than 7,000 Member Surgeons, the Society is recognized as a leading authority and information source on aesthetic and reconstructive plastic surgery. ASPS comprises more than 94 percent of all board-certified plastic surgeons in the United States. Founded in 1931, the Society represents physicians certified by The American Board of Plastic Surgery or The Royal College of Physicians and Surgeons of Canada. ASPS advances quality care to plastic surgery patients by encouraging high standards of training, ethics, physician practice and research in plastic surgery. 

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