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29.05.2017 | Original Paper | Ausgabe 5/2017 Open Access

European Journal of Plastic Surgery 5/2017

Lipofilling effects after breast cancer surgery in post-radiation patients: an analysis of results and algorithm proposal

Zeitschrift:
European Journal of Plastic Surgery > Ausgabe 5/2017
Autoren:
Manuel Debald, Thomas Pech, Christina Kaiser, Mignon-Denise Keyver-Paik, Gisela Walgenbach-Bruenagel, Joerg C. Kalff, Walther Kuhn, Klaus J. Walgenbach
Wichtige Hinweise
The original version of this article was revised due to a retrospective Open Access order.
MD and TP contributed equally
An erratum to this article is available at https://​doi.​org/​10.​1007/​s00238-017-1351-6.

Abstract

Background

Lipofilling or autologous fat transfer is an established technique in plastic surgery. Herein, we describe the lipofilling effects after implant-based breast reconstruction in post-radiation patients and propose an algorithm for indication of lipofilling.

Methods

Forty patients with a history of breast cancer were included in this retrospective analysis. Patients had undergone either breast conserving therapy or mastectomy. Twenty-six patients underwent additional radiation therapy. Patients were assessed using a post-radiation skin scoring classification.

Results

In total, 68 lipofilling procedures were analyzed. Scar release, skin softening, improved quality of life, and improvement of post-radiation findings are results of lipofilling with a closed filtration system. In all patients with post-surgical radiation, an improvement of tissue quality was observed. Staging revealed that lipofilling improved mean post-radiation skin scores of 2.40 ± 0.89 to 1.21 ± 0.76 (p ≤ 0.000). There was no recurrence of breast cancer in our study patients.

Conclusions

This study introduces an algorithm using lipofilling in reconstructive breast surgery and especially in post-radiation patients with low risks as well as very high acceptance in patients with various indications for this procedure. A regenerative aspect was also detectable in patients following radiation therapy and reconstruction. Lipofilling is a safe and effective procedure with a low incidence of minor complications. It is therefore a feasible method to resolve volume deficiencies and asymmetric results after oncologic breast surgery. Nevertheless, a prospective study has now been initiated focusing on the oncologic safety of lipofilling including ultrasound and radiological examinations to validate the findings of this initial study.
Level of Evidence: Level IV, therapeutic study.

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