Fat Transfer May Offer Another Breast Reconstruction Option After Mastectomy
Dutch study found rebuilding the breast with a patient's own fat had high satisfaction, low complications

Breast reconstruction using only a patient's own fat may provide another treatment option for some after mastectomy, especially those who do not want implants or may not be candidates for traditional flap surgery, according to a study in the October issue of Plastic and Reconstructive Surgery®, the official medical journal of the American Society of Plastic Surgeons (ASPS).

"There are still going to be patients that are going to go for the implant," said the study's lead author Andrzej A. Piatkowski de Grzymala, MD, PhD, a professor at Maastricht University Hospital. "There are still going to be patients wanting flap surgery, and there are going to be patients going for the autologous fat transfer. I think that is a good coexistence because there's no perfect reconstruction for patients."

An additional reconstruction option

The process happens in stages. Patients first use a device called the EVE-bra to stretch the skin on the chest after mastectomy.

Next, they undergo autologous fat transfer, a technique that removes fat by liposuction from areas of the body such as the abdomen, back, hips or thighs. The fat is then processed and injected into the chest to rebuild the breast.

Most patients needed around four sessions to achieve their desired results.

Patient satisfaction high

One advantage of the treatment is the breast rebuilt with a patient's own fat looks and feels like a natural breast, plus ages like one as well.

"It feels warm," said Dr. Piatkowski. "What is even more interesting is some breast sensation comes back over time, and you will never achieve this with an implant."

After a year, patients reported significant improvements in several quality-of-life measures, including psychosocial, sexual, and physical well-being as well as satisfaction with their breasts. Patients also stated they had improved satisfaction with their bodies because the liposuction offered the additional benefit of body contouring.

The authors concluded the treatment is a safe and effective breast reconstruction option with a low complication rate.

Trade-offs

However, some patients found the process burdensome and intense. It can take about a year to complete.

"What we hear from our patients is that it's a long journey," said Dr. Piatkowski. "But in the end, and we saw that when we asked our patients after a long time, they're very, very happy and they're very positive about their results."

Additionally, the EVE-bra can cause discomfort, skin irritation, blisters and itching.

In the future

The findings may eventually expand the conversation beyond implants and flap surgery for patients considering breast reconstruction after mastectomy. The study suggested autologous fat transfer may become a valuable additional option for breast reconstruction.

Plastic and Reconstructive Surgery® is published by Wolters Kluwer.

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Article: "Oral Antibiotics Do Not Prevent Infection or Implant Loss after Immediate Prosthetic Breast Reconstruction" (doi: 10.1097/PRS.0000000000010073)