Radiological findings in mammary autologous fat injections: A multi-technique evaluation

Costantini, Melania; Cipriani, Antonio; Belli, Paolo; Bufi, Enida; Fubelli, Rita; Visconti, Giuseppe; Salgarello, Marzia; Bonomo, Lorenzo

doi:10.1016/j.crad.2012.05.009

Cited by 62 publications

(46 citation statements)

References 29 publications

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“…Our data are relatively consistent with these reports noting that we found clinical evidence of fat necrosis in 8.8 % of patients, or 6.3 % of breasts, with a substantial increase in sensitivity for this finding afforded by further imaging. Our data are consistent with other reports suggesting that the harder you look for fat necrosis with multimodality imaging, the more likely you are to find it [7, 18]. The clinical impact of fat necrosis in this study was modest, as only 4 (2.9 %) patients required operative excision—two to rule out malignancy and two to address uncomfortable induration.…”

Section: Discussionsupporting

confidence: 90%

Fat Grafting with Tissue Liquefaction Technology as an Adjunct to Breast Reconstruction

et al. 2016

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BackgroundTissue liquefaction technology (TLT) delivers warmed saline from the liposuction cannula tip at low pressure pulses to disaggregate adipocytes. This technology differs significantly from that used in other liposuction devices including water jet-assisted liposuction. Here we introduce our early experience with this technology in the setting of fat transfer for revision breast reconstruction.MethodsA retrospective chart review of 136 consecutive patients who underwent fat harvest with TLT and subsequent transfer into 237 breast reconstructions was conducted at a single institution. This two-surgeon series examined donor and recipient site complication rates over a median follow-up of 143 days [87–233].ResultsThe overall complication rate was 28.7 %, of which the majority (22.1 %) was fat necrosis at the recipient site as documented by any clinical, imaging, or pathologic evidence. The abdomen served as the donor site for half of the cases. Donor site complications were limited to widespread ecchymosis of the donor site notable in 10.4 % of cases. Twenty-five percent of patients had received postmastectomy radiotherapy prior to fat transfer. Prior to revision with fat transfer, implant-based breast reconstruction was used in 75.5 % of cases, and autologous flaps in the remainder. Fat transfer was combined with other reconstructive procedures 94.1 % of the time.ConclusionsTLT can be used to harvest adipocytes for fat transfer with donor site morbidity and recipient site complications comparable to other modalities. The efficiency and quality of harvested fat makes this technology appealing for wide spread adoption during fat transfer.Level of Evidence IVThis journal requires that the authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.

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Section: Discussionsupporting

confidence: 90%

Fat Grafting with Tissue Liquefaction Technology as an Adjunct to Breast Reconstruction

et al. 2016

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“…An average of 50% (range: 3–100%) of study participants had radiation before undergoing AFG. 14,16,21,24–28,31–41 Of the 20 studies that reported proportion of patients who underwent radiation, 3 studies reported that all patients had prior radiation therapy. 27,38,39,42 There were no observed differences in patient characteristics, surgical characteristics, or outcomes between studies that reported higher proportions of patients who received radiation compared to studies with lower rates of radiation treatment.…”

Section: Resultsmentioning

confidence: 99%

The Safety, Effectiveness, and Efficiency of Autologous Fat Grafting in Breast Surgery

Spear

Coles²,

Leung³

et al. 2016

Plastic and Reconstructive Surgery - Global Open

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Background:For years, the safety and effectiveness of autologous fat grafting (AFG) for breast reconstruction have been in question, with particular concern over fat necrosis, calcifications, cyst formation, and interfering with the detection of breast cancer. However, increasing evidence suggests that the complication rates and clinical results are generally acceptable to both clinicians and patients. The emerging challenge is the numerous AFG techniques and systems, where there are limited knowledge and data. The objective of this study was to conduct a literature review that focuses on the safety, effectiveness, and efficiency of various AFG techniques as applied to the breast.Methods:A PubMed search using terms related to AFG was performed over a 5-year period (April 1, 2010–April 30, 2015). Original articles focused on AFG to the breast, with outcomes on safety, effectiveness, and efficiency, were included.Results:Five hundred ninety-eight articles were identified with 36 articles included (n = 4306 patients). Satisfaction rates were high although the prevalence of complications was low—similar to previous findings. Seven studies reported average operating room time with an overall mean of 125 minutes (range: 40–210). The mean volume of fat harvested was 558 mL (range: 120–1299), and fat injected was 145 mL (range: 20–607). A positive association between injection volume and operating time was observed.Conclusions:This review validates previous findings on the safety and effectiveness of AFG to the breast and highlights its efficiency. The efficiency data available, although limited, suggest that there is an opportunity to achieve time and cost savings while not sacrificing safety and effectiveness.

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“…Komorowska-Timek et al 41 Kim et al 40 Khan et al 39 Kaoutzanis et al 38 Ihrai et al 36 Hoppe et al 35 Helme et al 33 Gale et al 32 Fertsch et al 31 Doren et al 30 Delaporte et al 28 Constantini et al 27 Cohen et al 26 Brown et al 24 Bonomi et al 21 Beck et al 19 Bayti et al 18 Amar The meta-analysis was performed using the metafor package 16 of RStudio software, version 1.0.136 (R Foundation for Statistical Computing, Vienna, Austria). Summary measures (incidence rates) were pooled in a Poisson-normal random-effects model and presented as forest plots.…”

Section: Krastev Et Al (Unpublished)mentioning

confidence: 99%

“…Khan et al 39 Ihrai et al 36 Helme et al 33 Gale et al 32 Constantini et al 27 Brown et al 24 Beck et al 19 Bayti et al 18 Amar et al 17 Zhu et al 74 Tissiani and Alonso 72 Silva-Vergara et al 70 Seth et al 68 Rigotti et al 64 Riggio et al 63 Pinell-White et al 61 Petit et al 56 Noor et al 54 Missana et al 51 Masia et al 47 Manconi et al 46 Longo et al 45 Kronowitz et al 42…”

Section: Krastev Et Al (Unpublished)mentioning

confidence: 99%

Meta-analysis of the oncological safety of autologous fat transfer after breast cancer

Krastev

Schop

Hommes

et al. 2018

British Journal of Surgery

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Radiological findings in mammary autologous fat injections: A multi-technique evaluation

Cited by 62 publications

References 29 publications

Fat Grafting with Tissue Liquefaction Technology as an Adjunct to Breast Reconstruction

Fat Grafting with Tissue Liquefaction Technology as an Adjunct to Breast Reconstruction

The Safety, Effectiveness, and Efficiency of Autologous Fat Grafting in Breast Surgery

Meta-analysis of the oncological safety of autologous fat transfer after breast cancer

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