Autologous Fat Grafting after Breast Conserving Surgery – Breast-Imaging Changes and Patient-Reported Outcome

Publication date: Available online 24 August 2018

Source: Journal of Plastic, Reconstructive & Aesthetic Surgery

Author(s): A.A. Juhl, S. Redsted, T. Engberg Damsgaard

SUMMARY

Background

Autologous fat grafting (AFG) to the breast is known to cause radiologic breast-imaging changes. However, these changes have primarily been investigated in breast augmentation settings, whereas the radiologic breast-imaging changes after AFG in breast conserving surgery (BCS) patients have only been sparsely studied.

Methods

All women scheduled to receive AFG to BCS defects at our institution between 2014 and 2015 were eligible to participate. Before and after AFG, participants underwent radiologic breast-imaging and completed patient-reported outcome measures for body image, aesthetic breast appearance, scar quality and fear of cancer recurrence. Moreover, an observer evaluated changes in the aesthetic breast appearance and scar quality.

Results

Of 49 eligible patients, 42 were included. Participants received 1-3 AFG procedures, with a mean total grafted volume of 135±74 mL. Post-AFG breast-imaging was performed 9±5 (range 2-25) months after the final AFG procedure. Comparison of pre- and post-AFG radiologic breast images revealed that 21% had developed calcifications, 85% had developed oil cysts and 3% had developed increased scarring. Five patients presented with breast-imaging changes that required biopsy or additional radiologic evaluation. Significant improvements in breast aesthetic appearance, body image and scar quality were observed. No major surgical complications occurred. Minor surgical complications were observed in 3%.

Conclusions

Using AFG to reconstruct BCS defects induces considerable radiologic breast-imaging changes. Although the patients experience significant improvements in body image, breast aesthetic appearance and scar quality, the long-term effect of the breast-imaging changes warrants further investigation.