Evaluation of the role of autologous fat transfer in reduction of radiation complications in implant based breast reconstruction

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Abstract

Background
Implant-based breast reconstruction (IBBR) is the most common method of reconstruction after mastectomy. Postoperative radiotherapy is associated with a significant increase in complications. We report our experience with the use of autologous fat transfer (AFT) to reduce radiation complications in (IBBR) and assess survival of the transferred fat after breast radiation.
Patient and methods
This study was a prospective comparative study of 20 patients who were divided into two groups using the closed envelope technique: group (A) consisted of 10 patients treated with (AFT) during the first phase of (IBBR), group (B) consisted of 10 patients not treated with (AFT) during the first phase of (IBBR), both groups underwent postmastectomy radiotherapy (PMRT). A survey was done to analyze radiation complications and assessment of fat survival using computed tomography.
Results
Both groups (A) and (b) consist of 10 patients (9 unilateral and one bilateral) with 11 treated breasts in both groups Mean follow-up was 6 months. Complication rates in group (A) versus group (B) were as follows: surgical-site infection, 0% versus 9.1%; Superficial mastectomy flap necrosis, 9.1% versus 18.2%; wound dehiscence, 0% versus 9.1%; minor capsular contracture grade 1 2, 36.4% versus 54.5%; major capsular contracture grade 3,4 0 percent versus 18.2%; Radiation dermatitis 9.1% versus 27.3%; no hematoma, Seroma, Full-thickness mastectomy flap necrosis nor extrusion in both groups The average fat retention percentage after radiation was 74.82±4.21%.
Conclusions
Early data of the use of AFT as a protective measure in prepectoral IBBR in Patients with postmastectomy radiation therapy show promising results.

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