Autologous fat grafting to the postmastectomy irradiated chest wall prior to breast implant reconstruction: A series of 68 patients

Introduction. - After radiotherapy, breast reconstruction with an implant carries a high risk of failure and complication. Clinical and experimental studies have demonstrated that grafting adipose tissue (lipofilling) in an irradiated area enhances skin trophicity. Thus, we have started performing preliminary fat grafting to the irradiated chest wall prior to implant reconstruction in order to limit complications and failure risk. Patients and methods. - Patients were included in this study from 2007 to 2011. All patients had had mastectomy and irradiation for breast cancer. They all had one or more sessions of lipofilling prior to breast implant reconstruction. These patients were prospectively followed up in order to collect the following data: postoperative complications; cosmetic result; local breast cancer recurrences. Results. - Sixty-eight patients were included. The mean number of fat grafting sessions was 2.3 (range 1-6). An average volume of 115 mL (70-275) was injected each time. The mean volume of breast implants was 300 mL (185-400). The mean follow-up was 23 months (4 50). No breast cancer local recurrence was diagnosed during follow-up. Implant explantation was performed in one case (1.47%) The mean cosmetic result was 4.5/5. Conclusion. - Fat grafting to the irradiated chest wall prior to implant placement might be an alternative to flap reconstruction for patients who are not suitable or who refuse this option. (C) 2012 Elsevier Masson SAS. All rights reserved.