title: Outcomes of Prosthetic Reconstruction of Irradiated and Nonirradiated Breasts with Fat Grafting.
abstract: BACKGROUND
  Fat grafting may be beneficial in prosthetic reconstruction of irradiated tissues, but there is a paucity of data on the complication rates associated with this clinical scenario.
  
  
  METHODS
  All consecutive patients who had undergone fat grafting and prosthetic reconstruction from 2010 to 2013 were enrolled. Variables obtained related to fat grafting and history of irradiation. Implant-related complications in relation to irradiation status were also noted.
  
  
  RESULTS
  Eighty-five patients (age 49 ± 10 years) underwent 117 fat grafting procedures. The mean follow-up was 2.6 ± 0.7 years. Fat grafting was predominantly performed to correct soft-tissue deficiency [112 of 117 (95.7 percent)] or to alter skin after irradiation [five of 117 (4.3 percent)]. Thirty-two procedures (27.4 percent) were associated with a complication, with the most common being palpable fat necrosis (23.1 percent). Volume of transferred fat averaged 151.2 ± 76.6 ml per breast. Fat grafting complications did not depend on donor site, technique of fat processing, volume of transferred fat, number of procedures, or irradiation. Implant-related complications were observed after 26 of 117 overall procedures (22.2 percent). No association between implant-related complications and irradiation was observed (OR, 1.3; 95 percent CI, 0.4 to 4.1; p = 0.63). Overall complications following fat grafting in nonirradiated [37 of 82 (45.1 percent)] and irradiated [16 of 35 (45.7 percent)] breasts were not statistically different (OR, 1.02; 95 percent CI, 0.41 to 2.57; p = 0.96).
  
  
  CONCLUSIONS
  Similar outcomes of irradiated and nonirradiated prosthetic breast reconstruction can be achieved with additional fat grafting.
  
  
  METHODS
  Therapeutic, III.
authors.affiliation: Grand Rapids and Detroit, Mich.|From Advanced Plastic Surgery; College of Human Medicine and the Department of Surgery, Michigan State University; Grand Rapids Medical Education Partners; and the Department of Otolaryngology, Henry Ford Health System.
authors.forename: Ewa
authors.initials: E
authors.lastname: Komorowska-Timek
authors.affiliation: Grand Rapids and Detroit, Mich.|From Advanced Plastic Surgery; College of Human Medicine and the Department of Surgery, Michigan State University; Grand Rapids Medical Education Partners; and the Department of Otolaryngology, Henry Ford Health System.
authors.forename: Zaahir
authors.initials: Z
authors.lastname: Turfe
authors.affiliation: Grand Rapids and Detroit, Mich.|From Advanced Plastic Surgery; College of Human Medicine and the Department of Surgery, Michigan State University; Grand Rapids Medical Education Partners; and the Department of Otolaryngology, Henry Ford Health System.
authors.forename: Alan T
authors.initials: AT
authors.lastname: Davis
mesh_terms: D000328:Adult; D000368:Aged; D019928:Breast Implantation / Q000379:methods*; D001943:Breast Neoplasms / Q000532:radiotherapy* / Q000601:surgery; D018270:Carcinoma, Ductal, Breast / Q000532:radiotherapy* / Q000601:surgery; D002285:Carcinoma, Intraductal, Noninfiltrating / Q000532:radiotherapy* / Q000601:surgery; D018275:Carcinoma, Lobular / Q000532:radiotherapy* / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016015:Logistic Models; D008408:Mastectomy; D008875:Middle Aged; D003557:Phyllodes Tumor / Q000532:radiotherapy* / Q000601:surgery; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology; D018714:Radiotherapy, Adjuvant; D012189:Retrospective Studies; D050151:Subcutaneous Fat / Q000637:transplantation*; D016896:Treatment Outcome