Autologous fat grafting to the post mastectomy irradiated chest wall: A new way for minimal invasive breast reconstruction - A series of 54 patients
International Conference on Health Care and Neuroscience
April 08-09, 2019 | Zurich, Switzerland
Institut du Sein Nice Santa Maria, France
Posters & Accepted Abstracts : J Public Health Policy Plann
Introduction: Breast reconstruction after total
mastectomy and irradiation is a real challenge
for the surgical teams. And is a crucial step for
the patient in the life after breast cancer. The
effect of radiotherapy on the skin often leads to
preferring the reconstructions by flaps. However,
reconstructions by prosthesis carries a high risk of
complications and unsatisfactory cosmetic results.
The optimization of skin trophicity by lipofilling
and its positive impact on the results of secondary
prosthetic breast reconstruction led us to perform
an autologous fat grafting prior to secondary
implant breast reconstruction after mastectomy
Patients and method: All patients were treated at the same center between 2012 and 2015. They all had a total mastectomy and irradiation. They all had one or more sessions of lipofilling prior to breast implant reconstruction. Patients were followed to collect this data: postoperative complications, prosthesis removal, cosmetic result, and tumor recurrences.
Results: Fifty-four patients were included. The mean pre-pectoral lipofilling session was 1.1 (1-2). The average volume of fat injected is 150cc (80-250). The average time between the end of treatment and the first session of lipofilling is 20.4 months (3- 60). The mean volume of the prosthesis is 400cc (290-620). The mean follow-up time is 22 months. No local tumor recurrence was reported. One patient had a cutaneous necrosis after lipofilling. Implant explantation was performed in three cases (5.5%). The mean cosmetic result is 4.7 (3.5-5).
Conclusion: Pre-pectoral lipofilling prior to implant breast reconstruction improves the chances of success by optimizing the trophicity of the skin. It significantly reduces the risk of prosthesis explanation.
Therefore, this protocol allows us to propose a minimal invasive breast reconstruction, with no additional scar and no additional pain.