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The Volumetric Analysis of Fat Graft Survival in Breast Reconstruction

Choi, Mihye M.D.; Small, Kevin M.D.; Levovitz, Chaya B.A.; Lee, Christina M.S.; Fadl, Ahmed M.D.; Karp, Nolan S. M.D.

Plastic and Reconstructive Surgery: February 2013 - Volume 131 - Issue 2 - p 185–191
doi: 10.1097/PRS.0b013e3182789b13
Breast: Original Articles

Background: Fat grafting has emerged as a useful method for breast contouring in aesthetic and reconstructive patients. Advancements have been made in fat graft harvest and delivery, but the ability to judge the overall success of fat grafting remains limited. The authors applied three-dimensional imaging technology to assess volumetric fat graft survival following autologous fat transfer to the breast.

Methods: Fat grafting surgery was performed using a modified Coleman technique in breast reconstruction. Patients undergoing the procedure were entered into the study prospectively and followed. Three-dimensional imaging was performed using the Canfield Vectra system and analyzed using Geomagic software. Breasts were isolated as closed objects, and total breast volume was calculated on every scan.

Results: The data stratified patients into three groups with statistically significant parameters based on the volume of fat injected. The largest injected group (average volume, 151 cc) retained a volume of 86.9 percent (7 days postoperatively), 81.1 percent (16 days), 57.5 percent (49 days), and 52.3 percent (140 days). The smallest group (average, 51 cc) retained a volume of 87.9 percent (7 days postoperatively), 75.8 percent (16 days), 56.6 percent (49 days), and 27.1 percent (140 days). The intermediate group (average, 93 cc) retained 90.3 percent (7 days postoperatively), 74 percent (16 days), 45.7 percent (49 days), and 38.1 percent (140 days). Of note, irradiation or prior breast procedure type did not seem to affect the volume retention rate.

Conclusions: The authors' data suggest that fat retention is volume and time dependent. Patients receiving higher volumes of injected fat had slower volume loss and greater total volume retention.

New York and Stony Brook, N.Y.; and Philadelphia, Pa.

From the New York University Langone Medical Center, New York Presbyterian Hospital, Mount Sinai Medical Center, Philadelphia College of Osteopathic Medicine, and Stony Brook University Hospital.

Received for publication May 17, 2012; accepted August 23, 2012.

Presented at Plastic Surgery 2011: The Annual Meeting of the American Society of Plastic Surgeons, in Denver, Colorado, September 23 through 27, 2011; the 28th Annual Meeting of the Northeastern Society of Plastic Surgeons, in Amelia Island, Florida, October 20 through 23, 2011; and the 91st Annual Meeting of the American Association of Plastic Surgeons, in San Francisco, California, April 14 through 17, 2012.

Disclosure:The authors have no financial interest to declare in relation to the content of this article.

Nolan S. Karp, M.D.; 305 East 47th Street, Suite 1A, New York, N.Y. 10017,

©2013American Society of Plastic Surgeons