title: [Autologous fat grafting to the postmastectomy irradiated chest wall prior to breast implant reconstruction: a series of 68 patients].
abstract: BACKGROUND
  After radiotherapy, breast reconstruction with an implant carries a high risk of failure and complication. Clinical and experimental studies have demonstrated that grafting adipose tissue (lipofilling) in an irradiated area enhances skin trophicity. Thus, we have started performing preliminary fat grafting to the irradiated chest wall prior to implant reconstruction in order to limit complications and failure risk.
  
  
  METHODS
  Patients were included in this study from 2007 to 2011. All patients had had mastectomy and irradiation for breast cancer. They all had one or more sessions of lipofilling prior to breast implant reconstruction. These patients were prospectively followed up in order to collect the following data: postoperative complications; cosmetic result; local breast cancer recurrences.
  
  
  RESULTS
  Sixty-eight patients were included. The mean number of fat grafting sessions was 2.3 (range 1-6). An average volume of 115mL (70-275) was injected each time. The mean volume of breast implants was 300mL (185-400). The mean follow-up was 23months (450). No breast cancer local recurrence was diagnosed during follow-up. Implant explantation was performed in one case (1.47%) The mean cosmetic result was 4.5/5.
  
  
  CONCLUSIONS
  Fat grafting to the irradiated chest wall prior to implant placement might be an alternative to flap reconstruction for patients who are not suitable or who refuse this option.
authors.affiliation: L'institut du sein, 7, avenue Bugeaud, 75016 Paris, France.
authors.forename: I
authors.initials: I
authors.lastname: Sarfati
authors.forename: T
authors.initials: T
authors.lastname: Ihrai
authors.forename: A
authors.initials: A
authors.lastname: Duvernay
authors.forename: C
authors.initials: C
authors.lastname: Nos
authors.forename: K
authors.initials: K
authors.lastname: Clough
mesh_terms: D000273:Adipose Tissue / Q000637:transplantation*; D000328:Adult; D000368:Aged; D018427:Breast Implants; D001943:Breast Neoplasms / Q000532:radiotherapy* / Q000601:surgery*; D004954:Esthetics; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008408:Mastectomy; D008875:Middle Aged; D011183:Postoperative Complications / Q000517:prevention & control; D011475:Prosthesis Failure; D011832:Radiation Injuries / Q000601:surgery*; D035441:Thoracic Wall / Q000528:radiation effects* / Q000601:surgery*