Abstract
Lipofilling has recently gained popularity as a tool in primary treatment of breast cancer, and its association with two-stage implant breast reconstruction is considered as standard treatment in many centers. However, no data are available about the long-term results of the association of lipofilling in combination with expander-implant reconstruction. A retrospective analysis was conducted on patients treated between January 2010 and December 2014. Two groups were compared. Group 1 had a standard expander-implant two-stage reconstruction. Group 2 underwent hybrid breast reconstruction (HBR). Patient characteristics, hospitalization, outcomes, reoperation details, outpatient visits, and evaluation questionnaires were taken into consideration. Intergroup comparison was performed using Wilcoxon Mann-Whitney U test and Pearson’s chi-square test or Fisher’s exact test for categorical variables. Two hundred fourteen patients were evaluated: 130 patients in group 1 and 84 patients in group 2. Group 2 showed significant benefits over group 1 in terms of capsular contracture rate, breast pain, and displacement/rotation of the implant (p = 0.005). The HBR protocol is associated with lower rate of capsular contracture, less breast pain at long follow-up times, and lower overall rates of revision surgery compared to standard expander-implant reconstruction. A specific cost analysis will help further clarify the advantages of this protocol over a standard procedure.Level of Evidence: Level III, risk/prognostic, therapeutic study.
Highlights
Lipofilling is one of the most investigated topics in Plastic Surgery in recent decades, the use of adipose tissue for reconstruction purposes can be traced back to studies published a century ago
The aim of our study is to evaluate long-term results of a “hybrid breast reconstruction” (HBR) protocol [26], wherein fat grafting is performed during the course of the expander/ implant reconstruction
For group 2, we considered fat grafting procedures not included in HBR protocol, but which were conducted as secondary procedures
Summary
The aim of our study is to evaluate long-term results of a “hybrid breast reconstruction” (HBR) protocol [26], wherein fat grafting is performed during the course of the expander/ implant reconstruction
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