Long-term outcomes following fat grafting in prosthetic breast reconstruction: a comparative analysis
Plastic and Reconstructive Surgery, 07/11/2012
Seth AK et al. – The comparative analysis, the largest to date, suggests that FG after breast reconstruction does not adversely affect local tumor recurrence or survival on long–term follow–up. Surgeons may continue to utilize autologous FG as an aesthetic adjunct to prosthetic reconstruction with minimal complications. However, these preliminary results also indicate the need for multi–institutional, prospective studies to definitively establish its oncologic safety.Methods
- A retrospective review of consecutive patients undergoing mastectomy with immediate tissue expander reconstruction from 4/1998–8/2008 at one institution was performed.
- Demographic, operative, oncologic, and postoperative factors were recorded, including the use of FG. Mean follow–up was 42.1 +/– 28.8 and 43.6 +/– 27.2 months for non–FG and FG patients, respectively (p=0.63), including 24.8 +/– 5.9 months following the first FG procedure.
- Fisher's exact test, Student's t–test, and regression analysis were used for statistics.
- Review of 886 patients (n=1202 breasts) revealed no significant differences in demographics, operative characteristics, tumor staging, or radiation therapy exposure between FG (n=90 breasts) and non–FG (n=1112 breasts) patients.
- Ninety–nine FG procedures were performed an average of 18.3 months following reconstruction, with one complication of fat necrosis.
- FG did not affect local tumor recurrence or survival when compared to non–FG breasts.
- Having a complication following reconstruction, including a poor cosmetic result, was an independent predictor of undergoing subsequent FG (p<0.0001).