Fat Graft Survival Is Comparable Regardless of the Breast Reconstruction Method

Thursday, May 3, 2012: 3:05 PM
Kevin Small, MD1, Nolan S. Karp, MD2, Chaya Levovitz, BS3, Christina Lee, BA3 and Mihye Choi, MD4, (1)Institute of Reconstructive Plastic Surgery, NY Presbyterian Hospital-Cornell, New York, NY, (2)Institute of Reconstructive Plastic Surgery, New York University, New York, NY, (3)Plastic Surgery, NYU School of Medicine, NYC, NY, (4)Institute of Reconstructive Plastic Surgery, New York University School of Medicine, New York, NY
Goals/Purpose: Secondary refinements for the reconstructed breast are routine procedures as plastic surgeons continue to desire more natural results.  Autologous fat grafting (FG) has become an important option for correcting these deficiencies in volume.  Previous short-term studies have reported fifty percent volume retention after FG to the breast but have not answered whether the type of reconstruction affects retention outcomes. The following study applies 3D imaging to assess the stability of the breast following secondary FG in various recipient sites: implant breast reconstruction, breast lumpectomy defects, and autologous breast reconstruction. 

Methods/Technique: All patients receiving FG to the reconstructed breast from 2009-2010 were enrolled in the study.   FG surgery was performed using a modified Coleman technique. Preoperative and post-operative 3D scans at three months were obtained on all patients.  3D imaging was performed using the Canfield VECTRA system and analyzed using Geomagic software. As previously described, breasts were isolated as closed objects and total breast volume was calculated on every scan.

Results/Complications: In the observed period, total 116 patients underwent FG for secondary breast reconstruction.  Sixty-two implant breast reconstruction patients, fourteen breast lumpectomy patients, and forty autologous breast reconstruction patients received autologous fat and were studied preoperatively and postoperatively.  Average fat injected to the breast was 100cc.  At 3 months postoperatively, the implant subset had 42% volume retention and 0.41cc/day  esorption rate.   For the lumpectomy subset, the breast had 42% volume retention and 0.45cc/day resorption rate.  For the autologous subset, the breast had 44% volume retention and 0.55cc/day resorption rate.  No statistical difference existed between the three groups.

Conclusion: FG for secondary breast reconstruction is an essential tool to refine breast contour and has grown in popularity due to ease of use and low morbidity.  Our data suggests that breast reconstruction type does not affect percent volume retention and resorption rate.

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