The Role of Lipofilling After Breast Reconstruction: Evaluation of Outcomes and Patient Satisfaction with BREAST-Q.

Abstract

The aim of this study was to measure patient satisfaction using the BREAST-Q reconstruction module in patients selected for lipofilling procedures after implant breast reconstructions. Seventy patients who underwent breast reconstruction with or without delayed lipofilling were enrolled between 2011 and 2015, and they completed BREAST-Q surveys. We administered the questionnaire electronically 6months and 1year after surgery. We divided patients into two groups. In group A, we included patients (46) who underwent secondary lipofilling almost 1year after implant-based breast reconstruction; in group B (24), patients who underwent implant-based breast reconstruction without any lipofilling procedure. Statistical analysis was performed using descriptive and summary statistics to identify a central tendency between the two groups. All patients answered the postoperative BREAST-Q reconstruction module. The mean age of the patients was 41years. Eleven of the 70 patients underwent a bilateral mastectomy. The mean follow-up was 2.5years. The average amount of fat graft injected was 110cc. In group A, there were two patients who had a complication: 1 infection and 1 intraoperative implant rupture. The average number of lipofilling procedures was 2.2. After further analysis of the questionnaire, we observed that patients in group A obtained significantly better postoperative results than patients from group B (control) regarding the following items: the ability to wear more fitted clothing; the reconstructed breast softness; symmetry (breasts of equal size relative to the other); reconstructed breast look and touch; amount of implant rippling perceived by the patients; and psychosocial well-being and physical well-being: chest and upper body. Our results are encouraging regarding the use of autologous fat grafting to improve cosmetic outcomes and to reduce postoperative pain after breast reconstruction. This is the first study that applied BREAST-Q to breast lipofilling to demonstrate better outcomes achieved by patients who underwent secondary lipostructures. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .