Complete delayed breast reconstruction by lipofilling after skin-preserving mastectomy in breast cancer patients

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Abstract

Aim
To evaluate delayed lipofilling for complete breast reconstruction after skin-sparing mastectomy or nipple-sparing mastectomy in breast cancer patients in terms of patient satisfaction, aesthetic results, and complications.
Patients and methods
The study included 25 patients admitted to the Medical Research Institute Hospital, Alexandria University. They underwent delayed lipofilling by Coleman’s technique for total breast reconstruction after nipple-sparing mastectomy or skin-sparing mastectomy and immediate reconstruction by tissue expander or implant between January 2020 and August 2020. They were followed-up both clinically and radiologically for up to 1 year. The aesthetic outcome was assessed using Kyungpook National University Hospital questionnaires and volume reduction of fat injected was assessed by volumetric computed tomography assessment 3 months after the last session of lipofilling.
Results
The mean age of the patients was 42.56 ± 7.42 years. The mean time after the last radiotherapy setting before lipofilling was 7.19 ± 1.28 months; the shortest period was 6 months, while the longest one was 9e months. The aesthetic results were excellent. The patient satisfaction rate was very high, according to the patient surveys. The number of lipofilling sessions ranged from one to three sessions (average 1.96), and the injected graft volume per session varied from 80 to 470 ml (average 259.39 ml).
Conclusion
Delayed lipofilling for complete breast reconstruction is feasible in more than one session in motivated patients who want breast reconstruction and does not prefer other techniques for reconstruction like autologous flaps or implants. Lipofilling is a safe and effective technique with a low risk of complication and short-term hospitalization.

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