Breast SurgeryPatient-Reported Outcomes After Autologous Fat Grafting in Prosthetic Breast Reconstruction Prospective Cohort Study Using a Multivariate AnalysisSowa, Yoshihiro MD, PhDa,b; Inafuku, Naoki MDa; Tsuge, Itaru MD, PhDb; Yamanaka, Hiroki MD, PhDb; Morimoto, Naoki MD, PhDb Author Information From the aDepartment of Plastic and Reconstructive Surgery, Graduate School of Medical Science, Kyoto Prefectural University of Medicine bDepartment of Plastic and Reconstructive Surgery, Graduate School of Medicine and Faculty of Medicine, Kyoto University, Kyoto, Japan. Received August 30, 2022, and accepted for publication, after revision November 9, 2022. Conflicts of interest and sources of funding: none declared. Costs related to statistical analysis and manuscript publication were funded through the Department of Plastic and Reconstructive Surgery, Kyoto Prefectural University of Medicine. Data for this study are available upon request. The involvement of human participants in the study was reviewed and approved by the KPUM Institutional Review Board, and the study was conducted in accordance with the ethical standards of institutional and national research committees (Kyoto Prefectural University of Medicine IRBMED no. ERB-C-563-1). Participants provided written informed consent. Reprints: Yoshihiro Sowa, MD, PhD, Department of Plastic and Reconstructive Surgery, Kyoto University, 54 Shogoin Kawahara-cho, Sakyou-ku, Kyoto 606-8507, Japan. E-mail: [email protected]. Annals of Plastic Surgery 90(2):p 123-127, February 2023. | DOI: 10.1097/SAP.0000000000003383 Buy Metrics Abstract Introduction There is widespread recognition of the importance of assessment of patient satisfaction and well-being after breast reconstruction. However, few studies of fat grafting performed simultaneously with implant-based breast reconstruction (IBBR) have accounted for confounding factors, such as patient background and information bias. The aim of this study was to examine patient satisfaction and well-being using multivariate analysis of BREAST-Q scores in patients treated with IBBR combined with fat grafting. Methods Seventy-one consecutive patients who underwent IBBR with silicone breast implants were enrolled for a prospective cohort study. Among these patients, 56 responded to the BREAST-Q questionnaire, including 24 who underwent fat grafting at the same time as IBBR (FAT+ group) and 32 who underwent IBBR alone (FAT− group). The BREAST-Q questionnaire was completed 1 year after surgery. Statistical analysis was performed using descriptive and summary statistics to identify differences between the 2 groups. Results Logistic regression analysis showed that the FAT+ group was significantly more likely than the FAT− group to have satisfaction with breasts (P = 0.0201) and satisfaction with outcome (P = 0.0364). Conclusions Multivariate analysis with consideration of confounding factors indicated that addition of fat grafting to IBBR improves outcomes of breast reconstruction. These results suggest that a minor surgical procedure of fat grafting can improve patient satisfaction and outcomes after breast reconstruction. Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.