Factors of fat necrosis after breast reconstruction with autologous fat graft

Abstract

Objective To investigate the related factors of fat necrosis nodules after autologous fat grafting for breast reconstruction. Methods Different methods of purification, number of operations, and history of breast radiation were analyzed. The relationship between fat graft and necrosis were compared. A total of 48 patients undergoing autologous transplantation for breast reconstruction after radical mastectomy between January 2015 and June 2017 in Chinese Academy of Medical Sciences were retrospectively analyzed, and 51 breasts were used. Results After surgery, 9 cases of palpable nodules were found in the breast, including 8 cases in the centrifuge group and 1 case in the sedimentation group. There were 20 cases of multiple hypoechoic nodules in breast ultrasound, including 13 cases in the centrifugation group and 7 cases in the sedimentation group. The incidence of breast nodules in the centrifuge group was 33.33%, and the incidence of fat liquefaction cysts was 54.17%; the incidence of breast nodules in the sedimentation group was 3.7%, and the incidence of fat liquefaction cysts was 25.93%. In this study, there were 4 cases of breast fat filling surgery, 18 cases of fat graft for 2 times, 23 cases of breast fat filling for 3 times, and 6 cases of fat filling for 4 times; the more time of fat graft surgery, the higher of the fat necrosis incidence. There were 21 cases of breasts with radiotherapy history, 30 cases of breast without radiotherapy history, 7 cases of nodules after autologous fat transplantation and breast reconstruction in radiotherapy group, 2 cases of nodules that could be touched after autologous fat transplantation without breast reconstruction, and 2 cases with radiotherapy. The incidence of fat necrosis after fat transplantation breast reconstruction was higher than those without radiotherapy. Conclusions The incidence of fat necrosis after fat-purified with centrifugation autologous grafting for breast reconstruction is higher than that by sedimentation method. The higher rate of fat necrosis is observed after breast reconstruction with autologous fat grafting in radiotherapy than that without radiotherapy. Key words: Adipocytes; Transplantation; Fat necrosis; Nodules; Breast reconstruction