title: Is there an ideal donor site of fat for secondary breast reconstruction?
abstract: BACKGROUND
  Loss of volume after autologous fat transfer to the breast is well documented, and various methods to improve long-term survival of fat grafts have been investigated (including both distant and neighboring harvest sites), but no optimal technique has been identified.
  
  
  OBJECTIVE
  The authors compare fat graft survival from 2 anatomical donor sites to determine whether there is an optimal site for fat graft harvesting in breast reconstruction.
  
  
  METHODS
  Seventy-three patients (109 breasts) who received fat grafting to reconstructed breasts from 2009 to 2012 were enrolled in this retrospective study and divided into 2 groups: group A had fat harvested from the abdomen and group B from the thighs. Fat grafting was performed using a modified Coleman technique for symmetry. For all patients, 3-dimensional scans were obtained and volumes were analyzed.
  
  
  RESULTS
  Forty-six patients (66 breasts) received an average of 101 mL of fat injected from the abdomen, and 27 (43 breasts) received an average of 102 mL from the thighs. Group A had 82% volume retention at 16 days, 63% at 49 days, and 45% at 140 days. Group B had 86% at 16 days, 63% at 49 days, and 46% at 140 days (P > .05). Patients were also stratified by radiation exposure and volume injected; neither affected donor site volume retention (P > .05).
  
  
  CONCLUSIONS
  Our data suggest that donor site, regardless of volume injected or tissue radiation, did not affect volume retention in fat grafting. Longer-term studies are needed to assess the stability of the breast after fat grafting.
authors.affiliation: Dr Small is a plastic surgery resident in the Division of Plastic Surgery at New York Presbyterian Hospital/Weill Cornell Medical Center, New York, New York.
authors.forename: Kevin
authors.initials: K
authors.lastname: Small
authors.forename: Mihye
authors.initials: M
authors.lastname: Choi
authors.forename: Oriana
authors.initials: O
authors.lastname: Petruolo
authors.forename: Christina
authors.initials: C
authors.lastname: Lee
authors.forename: Nolan
authors.initials: N
authors.lastname: Karp
mesh_terms: D050153:Abdominal Fat / Q000637:transplantation*; D000328:Adult; D000368:Aged; D064592:Autografts; D005260:Female; D006801:Humans; D016462:Mammaplasty / Q000379:methods*; D008875:Middle Aged; D012189:Retrospective Studies; D050151:Subcutaneous Fat / Q000637:transplantation*; D013848:Thigh; D060053:Transplant Donor Site; D016896:Treatment Outcome
keywords: 3D imaging; breast surgery; donor site; fat grafting; viability