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DOI: 10.1055/s-0039-1700958
Application of Fat Grafting in Cosmetic Breast Surgery
Publication History
Publication Date:
15 February 2020 (online)
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Abstract
The role of fat grafting to the breasts has evolved in the recent past, gaining several new applications within both reconstructive and aesthetic surgery. Initially used for reconstructive purposes to fill lumpectomy defects or to correct residual contour deformities after breast reconstruction, it has since made its way into cosmetic breast surgery and has grown to encompass a wide variety of new indications. Fat grafting in aesthetic breast surgery may be performed as a form of primary autologous breast augmentation or as an adjunct to implant-based breast augmentation to disguise implant edges. It may also be used to provide added volume after explant surgery or to provide improvements in breast contour alongside mastopexy techniques. In this article, we will review the current applications of fat grafting in aesthetic breast surgery and provide an up-to-date summary of its reported outcomes, safety, and complications.
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References
- 1 American Society of Plastic Surgeons. 2018 National Plastic Surgery Statistics. Available at: https://www.plasticsurgery.org/documents/News/Statistics/2018/plastic-surgery-statistics-full-report-2018.pdf . Accessed August 2019
- 2 Abu-Ghname A, Perdanasari AT, Reece EM. Principles and applications of fat grafting in plastic surgery. Semin Plast Surg 2019; 33 (03) 147-154
- 3 Kling RE, Mehrara BJ, Pusic AL. , et al. Trends in autologous fat grafting to the breast: a national survey of the American Society of Plastic Surgeons. Plast Reconstr Surg 2013; 132 (01) 35-46
- 4 Coleman SR, Saboeiro AP. Primary breast augmentation with fat grafting. Clin Plast Surg 2015; 42 (03) 301-306 , vii
- 5 Groen JW, Negenborn VL, Twisk JW, Ket JC, Mullender MG, Smit JM. Autologous fat grafting in cosmetic breast augmentation: a systematic review on radiological safety, complications, volume retention, and patient/surgeon satisfaction. Aesthet Surg J 2016; 36 (09) 993-1007
- 6 Largo RD, Tchang LA, Mele V. , et al. Efficacy, safety and complications of autologous fat grafting to healthy breast tissue: a systematic review. J Plast Reconstr Aesthet Surg 2014; 67 (04) 437-448
- 7 Strong AL, Cederna PS, Rubin JP, Coleman SR, Levi B. The current state of fat grafting: a review of harvesting, processing, and injection techniques. Plast Reconstr Surg 2015; 136 (04) 897-912
- 8 Voglimacci M, Garrido I, Mojallal A. , et al. Autologous fat grafting for cosmetic breast augmentation: a systematic review. Aesthet Surg J 2015; 35 (04) 378-393
- 9 Martin-Padura I, Gregato G, Marighetti P. , et al. The white adipose tissue used in lipotransfer procedures is a rich reservoir of CD34+ progenitors able to promote cancer progression. Cancer Res 2012; 72 (01) 325-334
- 10 Orecchioni S, Gregato G, Martin-Padura I. , et al. Complementary populations of human adipose CD34+ progenitor cells promote growth, angiogenesis, and metastasis of breast cancer. Cancer Res 2013; 73 (19) 5880-5891
- 11 Petit JY, Botteri E, Lohsiriwat V. , et al. Locoregional recurrence risk after lipofilling in breast cancer patients. Ann Oncol 2012; 23 (03) 582-588
- 12 Rowan BG, Gimble JM, Sheng M. , et al. Human adipose tissue-derived stromal/stem cells promote migration and early metastasis of triple negative breast cancer xenografts. PLoS One 2014; 9 (02) e89595
- 13 Czerny V. Plastischer ersatz der brustdruse durch ein lipoma. Chir Kongr Verhandl 1895; 2: 216
- 14 Holländer E. Die kosmetische Chirurgie. In: Joseph M. , ed. Handbuch der Kosmetik. Leipzig: Verlag van Veit; 1912: 690-691
- 15 Fournier PF. Reduction syringe liposculpturing. Dermatol Clin 1990; 8 (03) 539-551
- 16 Report on autologous fat transplantation. ASPRS Ad-Hoc Committee on New Procedures, September 30, 1987. Plast Surg Nurs 1987; 7 (04) 140-141
- 17 Gutowski KA. ; ASPS Fat Graft Task Force. Current applications and safety of autologous fat grafts: a report of the ASPS fat graft task force. Plast Reconstr Surg 2009; 124 (01) 272-280
- 18 Simonacci F, Bertozzi N, Grieco MP, Grignaffini E, Raposio E. Procedure, applications, and outcomes of autologous fat grafting. Ann Med Surg (Lond) 2017; 20: 49-60
- 19 van Turnhout AA, Fuchs S, Lisabeth-Broné K, Vriens-Nieuwenhuis EJC, van der Sluis WB. Surgical outcome and cosmetic results of autologous fat grafting after breast conserving surgery and radiotherapy for breast cancer: a retrospective cohort study of 222 fat grafting sessions in 109 patients. Aesthetic Plast Surg 2017; 41 (06) 1334-1341
- 20 Oeffinger KC, Fontham ET, Etzioni R. , et al; American Cancer Society. Breast cancer screening for women at average risk: 2015 guideline update from the American Cancer Society. JAMA 2015; 314 (15) 1599-1614
- 21 Knackstedt RW, Gatherwright J, Ataya D, Duraes EFR, Schwarz GS. Fat grafting and the palpable breast mass in implant-based breast reconstruction: incidence and implications. Plast Reconstr Surg 2019; 144 (02) 265-275
- 22 Coleman SR, Saboeiro AP. Fat grafting to the breast revisited: safety and efficacy. Plast Reconstr Surg 2007; 119 (03) 775-785 , discussion 786–787
- 23 Crawford JL, Hubbard BA, Colbert SH, Puckett CL. Fine tuning lipoaspirate viability for fat grafting. Plast Reconstr Surg 2010; 126 (04) 1342-1348
- 24 Hamza A, Lohsiriwat V, Rietjens M. Lipofilling in breast cancer surgery. Gland Surg 2013; 2 (01) 7-14
- 25 Kakagia D, Pallua N. Autologous fat grafting: in search of the optimal technique. Surg Innov 2014; 21 (03) 327-336
- 26 Pu LL, Coleman SR, Cui X, Ferguson Jr RE, Vasconez HC. Autologous fat grafts harvested and refined by the Coleman technique: a comparative study. Plast Reconstr Surg 2008; 122 (03) 932-937
- 27 Ozsoy Z, Kul Z, Bilir A. The role of cannula diameter in improved adipocyte viability: a quantitative analysis. Aesthet Surg J 2006; 26 (03) 287-289
- 28 Coleman SR. Structural fat grafting: more than a permanent filler. Plast Reconstr Surg 2006; 118 (3, Suppl): 108S-120S
- 29 Coleman SR. Facial augmentation with structural fat grafting. Clin Plast Surg 2006; 33 (04) 567-577
- 30 Osinga R, Menzi NR, Tchang LA. , et al. Effects of intersyringe processing on adipose tissue and its cellular components: implications in autologous fat grafting. Plast Reconstr Surg 2015; 135 (06) 1618-1628
- 31 Eto H, Kato H, Suga H. , et al. The fate of adipocytes after nonvascularized fat grafting: evidence of early death and replacement of adipocytes. Plast Reconstr Surg 2012; 129 (05) 1081-1092
- 32 Serra-Mestre JM, Fernandez Peñuela R, Foti V, D'Andrea F, Serra-Renom JM. Breast cleavage remodeling with fat grafting: a safe way to optimize symmetry and to reduce intermammary distance. Plast Reconstr Surg 2017; 140 (05) 665e-672e
- 33 Delay E, Sinna R, Ho Quoc C. Tuberous breast correction by fat grafting. Aesthet Surg J 2013; 33 (04) 522-528
- 34 Kerfant N, Henry AS, Hu W, Marchac A, Auclair E. Subfascial primary breast augmentation with fat grafting: a review of 156 cases. Plast Reconstr Surg 2017; 139 (05) 1080e-1085e
- 35 Rosing JH, Wong G, Wong MS, Sahar D, Stevenson TR, Pu LL. Autologous fat grafting for primary breast augmentation: a systematic review. Aesthetic Plast Surg 2011; 35 (05) 882-890
- 36 Auclair E, Blondeel P, Del Vecchio DA. Composite breast augmentation: soft-tissue planning using implants and fat. Plast Reconstr Surg 2013; 132 (03) 558-568
- 37 Maione L, Caviggioli F, Vinci V. , et al. Fat graft in composite breast augmentation with round implants: a new concept for breast reshaping. Aesthetic Plast Surg 2018; 42 (06) 1465-1471
- 38 Özalp B, Aydinol M. Breast augmentation combining fat injection and breast implants in patients with atrophied breasts. Ann Plast Surg 2017; 78 (06) 623-628
- 39 Salibian AA, Frey JD, Bekisz JM, Choi M, Karp NS. Fat grafting and breast augmentation: a systematic review of primary composite augmentation. Plast Reconstr Surg Glob Open 2019; 7 (07) e2340
- 40 Mess SA. Lipoaugmentation following implant removal preferred by plastic surgeons and the general public. Plast Reconstr Surg Glob Open 2018; 6 (08) e1882
- 41 Biazus JV, Stumpf CC, Melo MP. , et al. Breast-conserving surgery with immediate autologous fat grafting reconstruction: oncologic outcomes. Aesthetic Plast Surg 2018; 42 (05) 1195-1201
- 42 Graf RM, Closs Ono MC, Pace D, Balbinot P, Pazio ALB, de Paula DR. Breast auto-augmentation (mastopexy and lipofilling): an option for quitting breast implants. Aesthetic Plast Surg 2019; 43 (05) 1133-1141
- 43 Petit JY, Maisonneuve P, Rotmensz N, Bertolini F, Rietjens M. Fat grafting after invasive breast cancer: a matched case-control study. Plast Reconstr Surg 2017; 139 (06) 1292-1296
- 44 Pu LL, Yoshimura K, Coleman SR. Future perspectives of fat grafting. Clin Plast Surg 2015; 42 (03) 389-394 , ix–x ix–x.
- 45 Mann RA, Ballard TNS, Brown DL, Momoh AO, Wilkins EG, Kozlow JH. Autologous fat grafting to lumpectomy defects: complications, imaging, and biopsy rates. J Surg Res 2018; 231: 316-322
- 46 Bravo FG. Parasternal infiltration composite breast augmentation. Plast Reconstr Surg 2015; 135 (04) 1010-1018
- 47 Ho Quoc C, Delaporte T, Meruta A, La Marca S, Toussoun G, Delay E. Breast asymmetry and pectus excavatum improvement with fat grafting. Aesthet Surg J 2013; 33 (06) 822-829
- 48 Khouri RK, Khouri Jr RK, Rigotti G. , et al. Aesthetic applications of Brava-assisted megavolume fat grafting to the breasts: a 9-year, 476-patient, multicenter experience. Plast Reconstr Surg 2014; 133 (04) 796-807 , discussion 808–809
- 49 Heit YI, Lancerotto L, Mesteri I. , et al. External volume expansion increases subcutaneous thickness, cell proliferation, and vascular remodeling in a murine model. Plast Reconstr Surg 2012; 130 (03) 541-547
- 50 Khouri RK, Schlenz I, Murphy BJ, Baker TJ. Nonsurgical breast enlargement using an external soft-tissue expansion system. Plast Reconstr Surg 2000; 105 (07) 2500-2512 , discussion 2513–2514
- 51 Delay E, Garson S, Tousson G, Sinna R. Fat injection to the breast: technique, results, and indications based on 880 procedures over 10 years. Aesthet Surg J 2009; 29 (05) 360-376
- 52 Chiu CH. Correction with autologous fat grafting for contour changes of the breasts after implant removal in Asian women. J Plast Reconstr Aesthet Surg 2016; 69 (01) 61-69
- 53 Uda H, Tomioka YK, Sugawara Y, Sarukawa S, Sunaga A. Shaping of the unaffected breast with Brava-assisted autologous fat grafting to obtain symmetry after breast reconstruction. Aesthet Surg J 2015; 35 (05) 565-573
- 54 Abboud MH, Dibo SA. Immediate large-volume grafting of autologous fat to the breast following implant removal. Aesthet Surg J 2015; 35 (07) 819-829
- 55 Hyakusoku H, Ogawa R, Ono S, Ishii N, Hirakawa K. Complications after autologous fat injection to the breast. Plast Reconstr Surg 2009; 123 (01) 360-370 , discussion 371–372
- 56 Spear SL, Pittman T. A prospective study on lipoaugmentation of the breast. Aesthet Surg J 2014; 34 (03) 400-408
- 57 Zocchi ML, Zuliani F. Bicompartmental breast lipostructuring. Aesthetic Plast Surg 2008; 32 (02) 313-328
- 58 Bennett KG, Qi J, Kim HM. , et al. Association of fat grafting with patient-reported outcomes in postmastectomy breast reconstruction. JAMA Surg 2017; 152 (10) 944-950
- 59 Brown AWW, Kabir M, Sherman KA, Meybodi F, French JR, Elder EB. Patient reported outcomes of autologous fat grafting after breast cancer surgery. Breast 2017; 35: 14-20
- 60 Qureshi AA, Odom EB, Parikh RP, Myckatyn TM, Tenenbaum MM. Patient-reported outcomes of aesthetics and satisfaction in immediate breast reconstruction after nipple-sparing mastectomy with implants and fat grafting. Aesthet Surg J 2017; 37 (09) 999-1008
- 61 Rehman J, Traktuev D, Li J. , et al. Secretion of angiogenic and antiapoptotic factors by human adipose stromal cells. Circulation 2004; 109 (10) 1292-1298
- 62 Bertolini F, Petit JY, Kolonin MG. Stem cells from adipose tissue and breast cancer: hype, risks and hope. Br J Cancer 2015; 112 (03) 419-423
- 63 Eterno V, Zambelli A, Pavesi L. , et al. Adipose-derived mesenchymal stem cells (ASCs) may favour breast cancer recurrence via HGF/c-Met signaling. Oncotarget 2014; 5 (03) 613-633
- 64 Zimmerlin L, Donnenberg AD, Rubin JP, Basse P, Landreneau RJ, Donnenberg VS. Regenerative therapy and cancer: in vitro and in vivo studies of the interaction between adipose-derived stem cells and breast cancer cells from clinical isolates. Tissue Eng Part A 2011; 17 (1-2): 93-106
- 65 Agha RA, Fowler AJ, Herlin C, Goodacre TE, Orgill DP. Use of autologous fat grafting for breast reconstruction: a systematic review with meta-analysis of oncological outcomes. J Plast Reconstr Aesthet Surg 2015; 68 (02) 143-161
- 66 De Decker M, De Schrijver L, Thiessen F, Tondu T, Van Goethem M, Tjalma WA. Breast cancer and fat grafting: efficacy, safety and complications-a systematic review. Eur J Obstet Gynecol Reprod Biol 2016; 207: 100-108
- 67 Gennari R, Griguolo G, Dieci MV. , et al. Fat grafting for breast cancer patients: from basic science to clinical studies. Eur J Surg Oncol 2016; 42 (08) 1088-1102
- 68 Groen JW, Negenborn VL, Twisk DJWR. , et al. Autologous fat grafting in onco-plastic breast reconstruction: a systematic review on oncological and radiological safety, complications, volume retention and patient/surgeon satisfaction. J Plast Reconstr Aesthet Surg 2016; 69 (06) 742-764
- 69 Krastev TK, Schop SJ, Hommes J, Piatkowski AA, Heuts EM, van der Hulst RRWJ. Meta-analysis of the oncological safety of autologous fat transfer after breast cancer. Br J Surg 2018; 105 (09) 1082-1097
- 70 Waked K, Colle J, Doornaert M, Cocquyt V, Blondeel P. Systematic review: the oncological safety of adipose fat transfer after breast cancer surgery. Breast 2017; 31: 128-136