Efficacy of autologous fat transfer for the correction of contour deformities in the breast: A systematic review and meta-analysis

Krastev, Todor K.; Alshaikh, Ghufran A.H.; Hommes, Juliëtte; Piatkowski, Andrzej; Hulst, René R W J van der

doi:10.1016/j.bjps.2018.05.021

Cited by 29 publications

(24 citation statements)

References 98 publications

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“…44,49 AFG is frequently employed to treat soft-tissue deformities and to improve contour. 40,41,52 Resorption of fatty tissue is the most common complication associated with AFG and occurs in around 45% to 48% of patients. [52][53][54][55] While resorption is unpredictable, the literature suggests that maintaining the viability of adipocyte-derived stem cells by using proper technique will help lower the risk of graft loss.…”

Section: Liposuction and Fat Graftingmentioning

confidence: 99%

Avoidance and Correction of Deformities in Body Contouring

et al. 2021

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Body contouring procedures are highly impactful because of their potential to improve a patient's quality of life. These procedures, particularly when performed on patients following massive weight loss, may require secondary intervention to treat residual contour abnormalities. Presently, there is a paucity of information in the literature detailing the avoidance and correction of body contouring deformities. Herein, we will discuss the management of patients seeking revisional body contouring procedures.

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Section: Liposuction and Fat Graftingmentioning

confidence: 99%

Avoidance and Correction of Deformities in Body Contouring

et al. 2021

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“…Several recent studies have demonstrated excellent outcomes and a clear efficay. [2][3][4] However, the theoretical oncological risk remained. The important work of Krastev et al and others has cleared this potential risk.…”

Section: Conflict Of Interests Disclosures: None Reportedmentioning

confidence: 99%

Long-term Follow-up of Autologous Fat Transfer vs Conventional Breast Reconstruction and Association With Cancer Relapse in Patients With Breast Cancer

et al. 2019

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IMPORTANCE Autologous fat transfer (AFT or fat grafting) has become an invaluable tool for the correction of disfiguring deformities after breast cancer surgery. However, clinical and animal studies have shown conflicting results regarding its oncologic safety. OBJECTIVE To determine whether exposure to AFT vs conventional breast reconstruction is associated with increased rates of cancer relapse in patients with breast cancer. DESIGN, SETTING, AND PARTICIPANTS This matched cohort study involved retrospective medical record review to identify all patients in a local patient database receiving AFT between 2006 and 2014. Each AFT case was matched with a nonexposed control patient with similar baseline characteristics. The mean (SD) follow-up of patients receiving AFT was 9.3 (4.9) years including 5.0 (1.7) years following AFT. Control patients were followed up for a mean (SD) of 8.6 (1.8) years from the primary surgery. Patients were identified through the local patient database of the Tergooi Hospital in Hilversum, the Netherlands. A total of 287 patients with breast cancer (300 affected breasts) who received AFT for breast reconstruction after cancer were included in the intervention group. Each AFT case was matched with a respective control patient based on age, type of oncologic surgery, tumor invasiveness, and disease stage. In addition, individual AFT-control pairs were selected to have the same locoregional recurrence-free interval at baseline. Data were analyzed between 2016 and 2017. EXPOSURES Reconstruction with AFT vs conventional breast reconstruction or none. MAIN OUTCOMES AND MEASURES Primary end points were the cumulative incidences of oncologic events in AFT and control patients and their respective hazard ratios. RESULTS Of the 587 total patients, all were women and the mean age was 48.1 years for the patients undergoing AFT and 49.4 years for the control patients. Eight locoregional recurrences were observed in the treatment group (287 patients) and 11 among the control group (300 patients), leading to an unadjusted hazard ratio of 0.63 (95% CI, 0.25-1.60; P = .33). No increased locoregional recurrence rates were seen in relevant subgroups based on the type of oncological surgery, tumor invasiveness, or pathological stage. In addition, no increased risks with AFT were detected with respect to distant recurrences or breast cancer-specific mortality. CONCLUSIONS AND RELEVANCE No significant differences in the locoregional recurrence rates between the AFT and control groups were observed after 5 years of follow-up. These findings confirm the results of previous studies; therefore, clinical evidence suggesting that AFT is associated with increased risk for cancer relapse is still lacking.

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“…However, as per the current method, the amount per transplant is limited; because there is no blood ow in transplanted adipose tissue, the tissue might become ischemic. If this happens, the majority of cases develop necrosis, thus making graft survival unstable and making multiple transplants necessary in multiple cases [2,[7][8][9]. Many studies have indicated that there is considerable discrepancy with regard to the related effects and complications of adipose tissue transplantation, which vary as per the level of skill of the surgeon.…”

Section: Introductionmentioning

confidence: 99%

Adipose Tissue Transplant Impregnated with Collagen Increases Engraftment by Promoting Cell Proliferation, Neovascularization, and Macrophage Activity in a Rat

Suzuki

Komiya

Inoue

et al. 2021

Preprint

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Objectives: To clarify the effect of impregnating transplanted adipose tissue with collagen on angiogenesis, cell proliferation, and tissue remodeling process and to reveal whether collagen impregnation contributes to improving the engraftment of transplanted adipose tissue in rats.Methods: Adipose tissue was harvested from the inguinal and injected into the back of the rat, in addition to collagen. Engraftment tissue was harvested, semi-quantitatively evaluated and underwent HE or Perilipin staining. Moreover, we evaluated viable adipocyte counts and neovascularization. Macrophages were evaluated using flow cytometry, and the adiponectin or VEGF mRNA was detected using real-time PCR. Results: By impregnating transplanted adipose tissue with collagen, higher engraftment rate semi-quantitatively and a greater number of new blood vessels histologically were identified. Perilipin staining revealed a higher adipocyte number. The total cell, M1 macrophage, and M2 macrophage count were higher. There was increased adiponectin mRNA significantly at week 4 compared to that at week 1 after transplantation. Note that the expression levels of VEGF mRNA increased.Discussion: In rats, collagen impregnation enhanced cell proliferation, induced M2 macrophages, which are involved in wound healing, and promoted adipocytes and neovascularization. Therefore, impregnating transplanted adipose tissue with collagen could increase the engraftment rate of adipose tissue.

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Efficacy of autologous fat transfer for the correction of contour deformities in the breast: A systematic review and meta-analysis

Cited by 29 publications

References 98 publications

Avoidance and Correction of Deformities in Body Contouring

Avoidance and Correction of Deformities in Body Contouring

Long-term Follow-up of Autologous Fat Transfer vs Conventional Breast Reconstruction and Association With Cancer Relapse in Patients With Breast Cancer

Adipose Tissue Transplant Impregnated with Collagen Increases Engraftment by Promoting Cell Proliferation, Neovascularization, and Macrophage Activity in a Rat

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