title: Fat Grafting with Tissue Liquefaction Technology as an Adjunct to Breast Reconstruction.
abstract: BACKGROUND
  Tissue liquefaction technology (TLT) delivers warmed saline from the liposuction cannula tip at low pressure pulses to disaggregate adipocytes. This technology differs significantly from that used in other liposuction devices including water jet-assisted liposuction. Here we introduce our early experience with this technology in the setting of fat transfer for revision breast reconstruction.
  
  
  METHODS
  A retrospective chart review of 136 consecutive patients who underwent fat harvest with TLT and subsequent transfer into 237 breast reconstructions was conducted at a single institution. This two-surgeon series examined donor and recipient site complication rates over a median follow-up of 143 days [87-233].
  
  
  RESULTS
  The overall complication rate was 28.7 %, of which the majority (22.1 %) was fat necrosis at the recipient site as documented by any clinical, imaging, or pathologic evidence. The abdomen served as the donor site for half of the cases. Donor site complications were limited to widespread ecchymosis of the donor site notable in 10.4 % of cases. Twenty-five percent of patients had received postmastectomy radiotherapy prior to fat transfer. Prior to revision with fat transfer, implant-based breast reconstruction was used in 75.5 % of cases, and autologous flaps in the remainder. Fat transfer was combined with other reconstructive procedures 94.1 % of the time.
  
  
  CONCLUSIONS
  TLT can be used to harvest adipocytes for fat transfer with donor site morbidity and recipient site complications comparable to other modalities. The efficiency and quality of harvested fat makes this technology appealing for wide spread adoption during fat transfer.
  
  
  METHODS
  This journal requires that the authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
authors: Division of Plastic and Reconstructive Surgery, Washington University School of Medicine, 1040 N. Mason, Ste 124, St Louis, MO, 63141, USA.
authors: Utku
authors: U
authors: Dolen
authors: Division of Plastic and Reconstructive Surgery, Washington University School of Medicine, 1040 N. Mason, Ste 124, St Louis, MO, 63141, USA.
authors: Justin B
authors: JB
authors: Cohen
authors: Division of Plastic and Reconstructive Surgery, Washington University School of Medicine, 1040 N. Mason, Ste 124, St Louis, MO, 63141, USA.
authors: Bo
authors: B
authors: Overschmidt
authors: Division of Plastic and Reconstructive Surgery, Washington University School of Medicine, 1040 N. Mason, Ste 124, St Louis, MO, 63141, USA.
authors: Marissa M
authors: MM
authors: Tenenbaum
authors: Division of Plastic and Reconstructive Surgery, Washington University School of Medicine, 1040 N. Mason, Ste 124, St Louis, MO, 63141, USA. myckatyn@wudosis.wustl.edu.
authors: Terence M
authors: TM
authors: Myckatyn
mesh_terms: D000273:Adipose Tissue / Q000637:transplantation*; D000328:Adult; D019928:Breast Implantation / Q000379:methods*; D001943:Breast Neoplasms / Q000601:surgery; D016009:Chi-Square Distribution; D015331:Cohort Studies; D003131:Combined Modality Therapy; D005260:Female; D005500:Follow-Up Studies; D006085:Graft Survival; D006801:Humans; D015187:Lipectomy / Q000379:methods*; D016462:Mammaplasty / Q000379:methods*; D008408:Mastectomy / Q000379:methods; D008875:Middle Aged; D012189:Retrospective Studies; D018570:Risk Assessment; D014182:Transplantation, Autologous; D014945:Wound Healing / Q000502:physiology*
keywords: Breast reconstruction; Fat graft; Fat transfer; Liposuction; Tissue liquefaction technology