Clinical PaperAutologous Fat Grafting in Secondary Breast ReconstructionLosken, Albert MD; Pinell, Ximena A. MD; Sikoro, Katherine MD; Yezhelyev, Maksym V. MD; Anderson, Erica MD; Carlson, Grant W. MDAuthor Information From the Emory Division of Plastic and Reconstructive Surgery, Atlanta, GA. Received September 21, 2010, and accepted for publication, after revision, September 26, 2010. Presented at the Annual Southeastern Society of Plastic and Reconstructive Surgeons Meeting, West Palm, FL, 2010. Reprints: Albert Losken, MD, 550 Peachtree Street NE, Suite 84300, Atlanta, GA 30308. E-mail: [email protected]. Annals of Plastic Surgery: May 2011 - Volume 66 - Issue 5 - p 518-522 doi: 10.1097/SAP.0b013e3181fe9334 Buy Metrics Abstract Autologous fat grafting has become a common technique for revisional breast surgery. The purpose of this series is to review our experience with fat grafting for the correction of acquired breast deformities. A retrospective review was performed on 107 patients with a history of breast cancer between 1996 and 2010, who had autologous fat grafting at the time of secondary breast reconstruction. The indications were for improvement in contour, shape, and volume of the breast following transverse rectus abdominis myocutaneous (TRAM) flap reconstruction (n = 55), latissimus dorsi with or without implant (n = 20), implant reconstruction (n = 20), and breast conservation therapy deformity (n = 12). The average volume of injection was 40 mL (range, 5–150 mL), the most common location being upper and medial quadrants. Fat was harvested mainly from the abdomen, thighs, and flanks. Complications occurred in 11% of the patients, and included fat necrosis, erythema, keloid scarring, and pain. Complications were higher when performed with implant reconstructions. Repeat fat injection was performed in 25% (n = 27/107), which increased with the length of follow-up. Patients with a history of radiation therapy had an increased incidence of repeat injections (36% vs. 18%). Patients with >6 months follow-up reported an improvement of about 83%. Autologous fat grafting is a safe and effective tool for secondary breast reconstruction. It is helpful in all types of reconstructions to improve contour, volume, and overall breast shape and symmetry. Repeat injections are often required and this is more common in patients with longer follow-up and in those with a history of radiation therapy. The popularity of this approach in reconstructive breast surgery will likely continue to increase. Copyright © 2011 Wolters Kluwer Health, Inc. All rights reserved.