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Abstract 29: Fat Graft Protocol for Total Autologous Reconstruction after Nipple-Sparing Mastectomy in Irradiated and Nonirradiated Breasts

Plastic and Reconstructive Surgery – Global Open: April 2016 - Volume 4 - Issue 4S - p 16
doi: 10.1097/01.GOX.0000488899.55864.44
PRS AAPS Oral Proofs 2016

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Fabio Santanelli di Pompeo, MD, PhD, Benedetto Longo, MD, PhD, Rosaria Laporta, MD, PhD

From the Sapienza University, Rome, Italy.

PURPOSE: Rate of fat grafting take may depend on several issues including irradiated recipient beds. Its use in reconstruction of previously irradiated nipple-sparing mastectomy (NSM) needs further clarification.

METHODS: Between 2008 and 2014, 42 NSMs, mean weight of 358 g (range, 220-470 g; 29 patients), were prospectively enrolled in fat grafting reconstruction and stratified into group A (28 nonirradiated) and group B (14 irradiated). Fat tissue was dry harvested with 2/3 mm cannula and 10-ml syringe, centrifuged at 3000 rpm/3 minutes, and injected with a blunt cannula and 1-ml syringe in subcutaneous and submuscular layers. The injected fat volume for each session was equal to one third of the mastectomy weight. The rule of 30% more was applied from the second to the last session for the incomplete graft taking. Variables were analyzed using the Student t test and Kruskal-Wallis test considering P ≤ 0.05 as significant.

RESULTS: The 2 groups were homogeneous regarding demographics (P > 0.05), whereas number of sessions, mean volume of first 2 treatments, and overall injected showed significant difference (P = 0.003, P = 0.004, and P = 0.005, respectively). Volume, shape, breast mound position, inframammary fold, scar location subscales, and global score had high evaluation in both groups (P > 0.05), whereas skin texture and total subscales scored less in group B than in group A (P = 0.006 and P = 0.003).

CONCLUSIONS: The first prospective fat transfer reconstruction series, with systematic approach, showed overall pleasing aesthetic outcomes but needs more fat transfer sessions in irradiated NSMs.

© 2016 American Society of Plastic Surgeons