Autologous fat grafting after breast conserving surgery: Breast imaging changes and patient-reported outcome

Background: Autologous fat grafting (AFG) to the breast is known to cause radiologic breast imaging changes. However, these changes have primarily been investigated in breast augmentation settings, whereas the radiologic breast imaging changes after AFG in patients who underwent breast conserving surgery (BCS) have been only sparsely studied. Methods: All women scheduled to receive AFG to reconstruct BCS defects at our institution between 2014 and 2015 were eligible to participate. Before and after AFG, participants underwent radiologic breast imaging and completed patient-reported outcome measures for body image, aesthetic breast appearance, scar quality, and fear of cancer recurrence. Moreover, an observer evaluated changes in the aesthetic breast appearance and scar quality. Results: Of 49 eligible patients, 42 were included. Participants received 1-3 AFG procedures, with a mean total grafted volume of 135 +/- 74 mL. Post-AFG breast imaging was performed 9 +/- 5 (range 2-25) months after the final AFG procedure. Comparison of pre- and post-AFG radiologic breast images revealed that 21% had developed calcifications, 85% had developed oil cysts, and 3% had developed increased scarring. Five patients presented with breast imaging changes that required biopsy or additional radiologic evaluation. Significant improvements were observed in breast aesthetic appearance, body image, and scar quality. No major surgical complications occurred. Minor surgical complications were observed in 3% of the patients. Conclusions: Using AFG to reconstruct BCS defects induces considerable radiologic breast imaging changes. Although the patients experience significant improvements in body image, breast aesthetic appearance, and scar quality, the long-term effect of breast imaging changes warrants further investigation. (C) 2018 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.