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Subfascial Primary Breast Augmentation with Fat Grafting: A Review of 156 Cases

Kerfant, Nathalie M.D.; Henry, Anne-Sophie M.D.; Hu, Weiguo M.D., Ph.D.; Marchac, Alexandra M.D.; Auclair, Eric M.D.

Plastic & Reconstructive Surgery: May 2017 - Volume 139 - Issue 5 - p 1080e–1085e
doi: 10.1097/PRS.0000000000003299
Cosmetic: Original Articles

Background: Composite breast augmentation with fat grafting and an implant has become very popular in the past 5 years. This achieves the core volume projection of an implant complemented by the natural appearance and feel of fat. However, no study has looked at the complications and reoperation rates of this technique.

Methods: A retrospective chart review examined all patients who underwent the combined use of an implant and fat grafting for primary breast augmentation.

Results: The study identified 156 patients between 2007 and 2013. The mean patient age was 31.7 years and the average body mass index was 18.85 kg/m2. The average implant size was 252 cc. Patients received a mean of 126 cc of fat (range, 30 to 250 cc) in subcutaneous soft tissue. Follow-up averaged 22.25 months (range, 1 to 86 months). The total complication rate was 7.7 percent and the reoperation rate was 9.94 percent. Baker grade II/III contracture was the most common complication [Baker grade II, n = 4 (2.56 percent); Baker grade III, n = 2 (2 percent)], followed by infections [n = 2 (1.28 percent)], hematoma [n = 2 (1.28 percent)], and malrotation [n = 1 (0.64 percent)]. Delayed reoperation was performed in nine patients (9.94 percent) after a mean interval of 31.7 months. Two patients who developed Baker grade III contractures needed surgery to correct the problem. Three cases (1.92 percent) required additional fat grafting for insufficient soft-tissue coverage. The mean volume of fat reinjection was 170 cc.

Conclusions: Composite breast augmentation is a valuable, stable, reliable technique in breast aesthetic surgery with good, natural-appearing results. It provides long-term aesthetic benefits and avoids the submuscular plane.

CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, IV.

Brest and Paris, France

From the Service de Chirurgie Plastique, Reconstructrice, et Esthétique, CHRU de Brest; and Clinique Spontini.

Received for publication June 12, 2016; accepted November 7, 2016.

Disclosure: The authors have no financial interests to declare in relation to the content of this article. No external funding was received.

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Nathalie Kerfant, M.D., Service de Chirurgie Plastique, Reconstructrice, et Esthétique, CHRU de Brest, Boulevard Tanguy Prigent, 29609 Brest cedex, France

©2017American Society of Plastic Surgeons