The Serial Free Fat Transfer in Irradiated Prosthetic Breast Reconstructions

Abstract

Free fat transfer is a safe and reliable technique in improving the outcomes of irradiated reconstructed breasts with implants.

Autologous Fat Transplantation – A Paradigm Shift in Breast Reconstruction

“…Panettiere et al reported similar improvement in radiation damage using fat grafting in 2009 (Panettiere et al, 2009). Their study population addressed 62 patients (20 active, 42 controls) who had undergone mastectomy, radiation and implant reconstruction.…”

“…A review of the literature reveals there are a growing number of published reports on the use of fat grafting in breast reconstruction after surgery for breast cancer. While some of them are case reports (Del Vecchio 2009, Babovic 2010, Panettiere 2011, Fitoussi 2009), a considerable number describe their experience with 40 or more patients (Spear 2005, Serra-Renom 2010, Rietjens 2011, Losken 2011, Missana 2007, Delay 2008, Panettiere 2009, Kanchwala 2009). …”

The Role of Free Fat Graft in Breast Reconstruction After Radiotherapy

“…An important reduction of fibrosis was also observed (Rigotti et al, 2007;Panettiere et al, 2009Panettiere et al, , 2011. The immunoregulatory activity and the capacity to modulate inflammation displayed by ADSCs can at least partially explain such behaviour.…”

“…The fat grafts can replace atrophic functional niches (the complex made of cell, extracellular and biochemical elements whom the adipose cell interacts with) with physiologic ones, thus playing their normalizing role on the receiving tissue. The normalizing role of free fat grafts in tissue regeneration was pointed out by several clinical studies (Moseley et al, 2006;Rigotti et al, 2007;Locke & de Chalain, 2008;Panettiere et al, 2009;Sarfati et al, 2011). In a recent work (Panettiere, 2011), USG and MR of a free fat grafts reconstructed breast suggested that the proliferation and differentiation of the ADSCs allowed the formation of a perfectly normal structural tissue.…”

Skin-Sparing Mastectomy and Breast Reconstruction: An Update for Clinical Practice

“…The processing techniques include, saline washing, centrifugation and/or enzymatic degradation and aims to reduce the incidence of fat necrosis and reabsorption. Serial lipofilling seems to be a safe and effective technique that can improve the contours of the reconstructed breast and create a subcutaneous plane in the irradiated breast, thus reducing implant related complications, such as capsule formation [56]. Asymmetric defects can be also corrected using lipomodelling.…”