Fat grafting in breast reconstruction. Retrospective study of satisfaction and quality of life about 68 patients

Background. - Evaluate the aesthetic clinical results, satisfaction and quality of life related to health in patients who underwent breast reconstruction by exclusive lipofilling or in addition to other surgical techniques. Means and methods. - A retrospective observational study was carried between 2009 and 2014 in four groups of patients who underwent a lipofilling by the same operator either after a conservative treatment (group 1), or exclusively (group 2), or after a flap (group 3) or implants (group 4). The sociodemographic data related to lipofilling or tumor pathology were collected and reported in a software designed for this study. Satisfaction and quality of life after lipofilling was assessed using the questionnaire Q BREAST (c) postoperative reconstruction module. Results. - One hundred and seventy lipofilling procedures were performed in 68 patients. The average volume transferred was 1421.2 cm(3) for the exclusive lipofilling group and the average number of sessions was 4.9 spread over a period of 15.6 months on average. In adjuvant technique or conservative surgery, the average total volume transferred was 212.2 cm(3) and the average number of sessions was 1.4. The abdomen was the site most used donor and the posterior thigh exclusively used in exclusive reconstruction. The cytosteatonecrosis rate was 8.8 % (n = 6). A single case of infection was noted. The tumor recurrence at ten months after lipofilling concerned two patients. The response rate was 80.8 %. The lipofilling improves the final cosmetic result with a rate of 91.1 % of patients satisfied or very satisfied with their breast. In all, 95.4 % of patients in the exclusive lipofilling group found a secondary benefit after surgery. Quality of life after lipofilling is also improved socially and sexually in the four groups with better results in patients who underwent conservative treatment. Conclusion. - The lipofilling is a simple, reliable technique, requiring a learning curve, improving the final aesthetic result and the quality of life it is used exclusively or to complement other techniques. (C) 2015 Elsevier Masson SAS. All rights reserved.