Fat Grafting in Breast Reconstruction

Turner, Acara E.; Abu‐Ghname, Amjed; Davis, Matthew J.; Winocour, Sebastian; Hanson, Summer E.; Chu, Carrie K.

doi:10.1055/s-0039-1700959

Cited by 55 publications

(43 citation statements)

References 61 publications

(96 reference statements)

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“…During the last few years, SVF-based autologous cellular therapies have been tested in several clinical settings, like scars [ 2 , 7 ], hemifacial atrophy [ 8 ], breast reconstruction [ 9 ], wound healing and cancer therapy [ 10 ], hair regrowth [ 11 ], breast augmentation [ 12 ], and in vitro applications [ 13 ].…”

Section: Introductionmentioning

confidence: 99%

Systematic Review: Allogenic Use of Stromal Vascular Fraction (SVF) and Decellularized Extracellular Matrices (ECM) as Advanced Therapy Medicinal Products (ATMP) in Tissue Regeneration

Gentile

Sterodimas

Pizzicannella

et al. 2020

IJMS

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Stromal vascular fraction (SVF) containing adipose stem cells (ASCs) has been used for many years in regenerative plastic surgery for autologous applications, without any focus on their potential allogenic role. Allogenic SVF transplants could be based on the possibility to use decellularized extracellular matrix (ECM) as a scaffold from a donor then re-cellularized by ASCs of the recipient, in order to develop the advanced therapy medicinal products (ATMP) in fully personalized clinical approaches. A systematic review of this field has been realized in accordance with the Preferred Reporting for Items for Systematic Reviews and Meta-Analyses-Protocols (PRISMA-P) guidelines. Multistep research of the PubMed, Embase, MEDLINE, Pre-MEDLINE, PsycINFO, CINAHL, Clinicaltrials.gov, Scopus database, and Cochrane databases has been conducted to identify articles and investigations on human allogenic ASCs transplant for clinical use. Of the 341 articles identified, 313 were initially assessed for eligibility on the basis of the abstract. Of these, only 29 met all the predetermined criteria for inclusion according to the PICOS (patients, intervention, comparator, outcomes, and study design) approach, and 19 have been included in quantitative synthesis (meta-analysis). Ninety-one percent of the studies previously screened (284 papers) were focused on the in vitro results and pre-clinical experiments. The allogenic use regarded the treatment of perianal fistulas, diabetic foot ulcers, knee osteoarthritis, acute respiratory distress syndrome, refractory rheumatoid arthritis, pediatrics disease, fecal incontinence, ischemic heart disease, autoimmune encephalomyelitis, lateral epicondylitis, and soft tissue defects. The information analyzed suggested the safety and efficacy of allogenic ASCs and ECM transplants without major side effects.

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Section: Introductionmentioning

confidence: 99%

Systematic Review: Allogenic Use of Stromal Vascular Fraction (SVF) and Decellularized Extracellular Matrices (ECM) as Advanced Therapy Medicinal Products (ATMP) in Tissue Regeneration

Gentile

Sterodimas

Pizzicannella

et al. 2020

IJMS

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“…Autologous fat grafting is a powerful tool to improve contour irregularities and possibly to increase the volume if used in a large quantity. 26 However, around 20% of transferred fat is subject to resorption. 28 Therefore, multiple fat grafting procedures is often required to obtain a desired volume.…”

Section: Discussionmentioning

confidence: 99%

Secondary Implant Augmentation in the Subpectoral Plane following Abdominal-based Perforator Flaps for Breast Reconstruction

Alhefzi

Voineskos

Coroneos

et al. 2020

Plastic and Reconstructive Surgery - Global Open

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Background: Abdominal-based perforator flaps are the gold standard for autologous breast reconstruction. However, among patients with a small-to-medium amount of redundant abdominal tissue, this may result in an inadequate breast mound. Secondary implant augmentation has been reported as one method to augment volume, address breast mound asymmetry, and enhance overall aesthetic outcome. We aim to analyze postoperative complications associated with the secondary implant augmentation following a primary breast reconstruction with abdominal perforator flaps. Methods: This retrospective study included patients who underwent secondary implant augmentation following abdominal-based perforator flap breast reconstruction. Patient characteristics, immediate versus delayed reconstruction, type of flap used, indication for secondary augmentation as well as perioperative and postoperative complication including flap or implant loss were reviewed and analyzed. Results: Twenty-four patients met inclusion criteria. Forty flaps were performed (16 bilateral and 8 unilateral). A total of 36 implants were placed in subpectoral plane in a secondary revision procedure. The mean time between secondary augmentation and index procedure was 22 months. Average implant volume was 270 g. No intraoperative complication or flap loss was recorded. Postoperative surgical site infection occurred in a total of 4 patients (17%) with 3 patients requiring explantation of a total of 4 implants. Conclusions: Secondary augmentation of abdominal-based perforator flap using a permanent implant is an effective method to address volume and asymmetry and to enhance aesthetic outcome. In our study, however, we observed a higher than expected rate of postoperative infection.

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“…Since Tuner and Bayram used autologous adipose tissue for facial injuries and breast reconstruction after total mastectomy, autologous adipose tissue transplantation had undergone numerous developments ( 20 , 21 ). Recently, with the standardization of liposuction surgery and the in-depth understanding of adipocytes and adipose-derived stem cells, autologous adipose tissue transplantation has once again become a hot research topic.…”

Section: Discussionmentioning

confidence: 99%

An experimental study on the prosthesis produced by inactivated autologous subcutaneous adipose tissue and skin dermal tissue in a mini-pig model

Jiang¹,

Pan²,

Huang³

et al. 2020

Transl Cancer Res TCR

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Background: Autologous adipose tissue grafting is a valuable strategy for breast reconstruction in breast cancer patients. However, adipose tissue is absorbed and liquefies easily, and the cosmetic effects do not last.The purpose of this study is to evaluate the cosmetic effects and histopathologic changes of the prostheses produced by inactivated autologous subcutaneous adipose tissue and dermal outer capsule in the mini-pig model.Methods: This prospective study was conducted in 6 Bama adult female mini-pigs weighing 15.5-20 kg.Autologous subcutaneous adipose tissue and dermis were harvested and made into the different prostheses.Then, the prostheses were implanted into abdominal subcutaneous tissue of the mini-pigs. At the 14 th and 30th day after implantation, the skin appearances were observed, and the prostheses were harvested. The histopathologic changes of adipocytes and dermis in the different prostheses were evaluated. Results:In vitro experiments showed that there were no significant changes in the size and histomorphology of autologous adipose tissue and/or dermis in the different prostheses. However, the results of the in vivo experiment found that the prosthesis produced by the inactivated adipose tissue with a dermal outer capsule produced the best cosmetic effect and the least fibrous connective tissue proliferation around the prosthesis. Moreover, the fewest proliferative fibrous connective tissues and infiltrated inflammatory cells were found in the adipocytes wrapped by dermis. The adipocyte morphology was normal.Conclusions: Results in this animal model indicated that the prosthesis produced by inactivated autologous subcutaneous adipose tissue with a dermal outer capsule may be a promising prosthesis for breast reconstruction. Validation of this new prosthesis requires more experiments to assess the long-term cosmetic effects and histopathologic changes.

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Fat Grafting in Breast Reconstruction

Cited by 55 publications

References 61 publications

Systematic Review: Allogenic Use of Stromal Vascular Fraction (SVF) and Decellularized Extracellular Matrices (ECM) as Advanced Therapy Medicinal Products (ATMP) in Tissue Regeneration

Systematic Review: Allogenic Use of Stromal Vascular Fraction (SVF) and Decellularized Extracellular Matrices (ECM) as Advanced Therapy Medicinal Products (ATMP) in Tissue Regeneration

Secondary Implant Augmentation in the Subpectoral Plane following Abdominal-based Perforator Flaps for Breast Reconstruction

An experimental study on the prosthesis produced by inactivated autologous subcutaneous adipose tissue and skin dermal tissue in a mini-pig model

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