Autologous fat graft in radiated tissue prior to alloplastic reconstruction of the breast: report of two cases.
BACKGROUND
The new indications for radiotherapy in the cure of breast cancer lead to an increasing number of candidates for this adjuvant treatment. However, it raises some concerns with respect to the prosthetic reconstruction of the breast. In fact, the use of implants in the irradiated breast is discouraged by many authors because of the high rate of complications. In these cases autologous tissue reconstruction is being recommended. However, not every patient is a candidate for autologous tissue reconstruction. Furthermore, not all radiotherapies are comparable in dose, timing, and patient tolerance. In this article we present the preliminary results of an alternative surgical management in oncoplastic breast surgery consisting of fat injections before implant placement.


METHODS
Six months after the last radiation treatment, a lumpectomy patient and a modified radical mastectomy patient each underwent two sessions of fat injection prior to implant placement, with a 3-month interval in between sessions. The implants were placed 3 months after the last fat injection.


RESULTS
There was a 12-month follow-up for the modified radical mastectomy case and a 18-month follow-up for the lumpectomy case. In both cases we report no postoperative complications, Baker grade 1 capsule contracture, good aesthetic outcome, and high patient satisfaction.


CONCLUSIONS
The preliminary results show that fat injection in irradiated tissue prior to breast alloplastic reconstruction may reduce the radiation-related complications on implants. Benefits from fat grafting are in keeping with the theoretical basis of this surgery. Larger studies are needed to confirm our observations.
Salgarello
Marzia
M
Department of Plastic and Reconstructive Surgery, Catholic University of Sacro Cuore, University Hospital A. Gemelli, Largo A. Gemelli 8, 00168, Rome, Italy. m.salgarello@mclink.it
Visconti
Giuseppe
G
Farallo
Eugenio
E
D000273:Adipose Tissue / Q000637:transplantation*; D000328:Adult; D001940:Breast / Q000528:radiation effects*; D018427:Breast Implants; D001943:Breast Neoplasms / Q000532:radiotherapy / Q000601:surgery; D005260:Female; D006801:Humans; D016462:Mammaplasty / Q000379:methods*; D015411:Mastectomy, Modified Radical / Q000009:adverse effects*; D015412:Mastectomy, Segmental / Q000009:adverse effects*; D008875:Middle Aged; D017060:Patient Satisfaction; D011183:Postoperative Complications / Q000601:surgery; D018714:Radiotherapy, Adjuvant / Q000009:adverse effects; D019651:Plastic Surgery Procedures / Q000009:adverse effects; D014182:Transplantation, Autologous