Lipofilling and Breast Reconstruction after Partial or Total Mastectomy

Author(s): Catherine Bouteille, Marie Bannier, Laura Sabiani, Aurore Van Troy, Max Buttarelli, Arthur Bertrand, Axelle Charavil, Monique Cohen, Gilles Houvenaeghel

Background: To describe the fat harvesting, applications and outcomes of autologous fat grafting in breast reconstruction and to explore this promising technique with new breast reconstruction applications.

Methods: Literature review of publications on fat grafting.

Results: Lipofilling has become increasingly popular. Several modifications have been made to the procedure. The “wet” method involves fluid injection at the donor site, facilitates lipoaspiration and appears to minimize ecchymosis. Low-speed centrifugation is preferred to high-speed centrifugation, sedimentation or filtration. Fat grafting is not only good filler but also improves the cutaneous trophicity. Complications of lipofilling are minimal and include pain, infection, ecchymosis on the donor site and necrosis and calcifications on the sample site. Several systematic reviews and meta-analyses have also confirmed its oncological safety. Initially used to improve breast implant or flap reconstruction, this technique is currently being extended to exclusive immediate or delayed breast reconstruction.

Conclusion: Adipose tissue is an ideal filler because it is readily available, easily obtained with low donor site morbidity, repeatable, inexpensive, versatile and biocompatible. The simplicity of the surgical technique and equipment required, and the high satisfaction rate confirm that lipofilling should be included in the panel of choice of breast reconstruction techniques.