title: Autologous Fat Grafting After Breast Reconstruction in Postmastectomy Patients: Complications, Biopsy Rates, and Locoregional Cancer Recurrence Rates.
abstract: BACKGROUND
  Autologous fat grafting is widely used for refinements in postmastectomy breast reconstruction. However, there are few studies evaluating outcomes in this patient population. The purpose of this study was to assess outcomes of autologous fat grafting after breast reconstruction in postmastectomy patients.
  
  
  METHODS
  We retrospectively reviewed the records of consecutive postmastectomy patients who underwent autologous fat grafting after breast reconstruction at a university center over a 5-year period. Patients with at least 6 months of follow-up were included. Medical records were reviewed for demographics, operative details, complications, incidence of palpable masses, and/or suspicious breast imaging findings requiring biopsy, and locoregional cancer recurrence. Descriptive statistics were generated.
  
  
  RESULTS
  Between January 2008 and July 2013, 108 women and a total of 167 breast reconstructions underwent autologous fat grafting for revision of postmastectomy breast reconstruction. Their ages ranged from 22 to 71 years (mean, 48 years). Fat grafts were harvested, processed, and injected using the Coleman technique. The mean number of fat grafting procedures was 1.3 (range, 1-4) per breast. Follow-up ranged from 6 to 57 months (mean, 20.2 months). Fifty-three (31.7%) breasts underwent imaging after autologous fat grafting. Suspicious imaging findings requiring biopsy were discovered in 4 (2.4%) breasts, and clinically palpable lesions combined with suspicious imaging findings requiring biopsy were present in another 4 (2.4%) breasts. All 8 biopsies showed fat necrosis, scar, or oil cysts without evidence of malignancy. One (0.6%) local complication (a wound infection at the recipient site requiring oral antibiotics) after autologous fat grafting was reported. During the limited follow-up period, there were no locoregional cancer recurrences.
  
  
  CONCLUSIONS
  Autologous fat grafting in conjunction with breast reconstruction resulted in a biopsy rate of 4.8%, and no cases of locoregional cancer recurrence were observed. Based on these preliminary findings, autologous fat grafting appears to be a relatively safe procedure for refinement of the reconstructed breast in postmastectomy patients.
authors.affiliation: From the *Department of Surgery, Saint Joseph Mercy Health System; †Section of Plastic Surgery, Department of Surgery, University of Michigan Health System; and ‡Department of Biostatistics, University of Michigan, Ann Arbor, MI.
authors.forename: Christodoulos
authors.initials: C
authors.lastname: Kaoutzanis
authors.forename: Minqiang
authors.initials: M
authors.lastname: Xin
authors.forename: Tiffany N S
authors.initials: TN
authors.lastname: Ballard
authors.forename: Kathleen B
authors.initials: KB
authors.lastname: Welch
authors.forename: Adeyiza O
authors.initials: AO
authors.lastname: Momoh
authors.forename: Jeffrey H
authors.initials: JH
authors.lastname: Kozlow
authors.forename: David L
authors.initials: DL
authors.lastname: Brown
authors.forename: Paul S
authors.initials: PS
authors.lastname: Cederna
authors.forename: Edwin G
authors.initials: EG
authors.lastname: Wilkins
mesh_terms: D000328:Adult; D000368:Aged; D001706:Biopsy; D001943:Breast Neoplasms / Q000473:pathology / Q000601:surgery*; D018270:Carcinoma, Ductal, Breast / Q000473:pathology / Q000601:surgery*; D002285:Carcinoma, Intraductal, Noninfiltrating / Q000473:pathology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016462:Mammaplasty / Q000379:methods*; D008408:Mastectomy; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology / Q000473:pathology; D011183:Postoperative Complications / Q000453:epidemiology; D012189:Retrospective Studies; D050151:Subcutaneous Fat / Q000637:transplantation*; D014182:Transplantation, Autologous; D016896:Treatment Outcome