Aesthetic Breast Augmentation Using Autologous Fat Grafting: Indications, Patient Assessment, and Comparison Between Different Processing Methods in 204 Cases

Fat grafting in autologous breast reconstruction: applications, outcomes, safety, and complications

“…For these reasons, surgeons have evolved implant-based surgeries to include autologous fat grafting, either in one setting or as a delayed surgical procedure, as an adjunct for improving contouring and correcting residual deformities. In the two-staged approach, delayed fat grafting is performed to reduce irregularities or implant delineations which may result from the implant folding over time [9,11,[23][24][25] . Studies have shown high levels of patient satisfaction and low complication rates with this technique [26][27][28] .…”

“…Delayed grafting is often favored as the recipient tissue bed becomes more vascularized with time and yields increased graft retention. Alternatively, pre-pectoral fat grafting may be performed before implant insertion to increase skin quality and flexibility, improve vascularization, and achieve better overall aesthetic outcomes [24,25,31,32] . Sforza and Spear (2021) proposed that the future of hybrid procedures should include creating a concept for hybrid breast augmentation surgery that provides reproducibility, predictability, and better surgical outcomes based on a safe 3D algorithm [33] .…”

“…Challenges of implant reconstruction include a high early and longterm failure rate, especially when used following radiation therapy. As it is not always possible to address implant failure or unnatural feel with adjunct fat grafting, many patients opt for flap-based reconstruction [25] . Further, autologous reconstruction can be more cost-effective in the long term compared to implants when considering follow-up health care use required to address adverse events.…”