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Original Article Plastic and Aesthetic Research

Fat injection to correct contour deformities

of the reconstructed breast: a single

surgeon experience

Youssef Tahiri , Jonathan Kanevsky , Joshua Vorstenbosch , James Lee , Karl Schwarz 4
3
2
1
2
1 Department of Surgery, Division of Plastic and Reconstructive Surgery, Riley Hospital for Children, Indiana University, Indianapolis,
IN 46202, USA.
2 Department of Surgery, Division of Plastic and Reconstructive Surgery, McGill University Health Centre, Montreal, QC H3G 1B3,
Canada.
3 Department of Surgery, Section of Plastic Surgery, University of Manitoba, Winnipeg, MB R3T 2N2, Canada.
4 Schwarz Plastic Surgery, Montreal, QC H3G 1B9, Canada.
Address for correspondence: Dr. Karl Schwarz, Schwarz Plastic Surgery, Montreal, QC H3G 1B9, Canada. E-mail: kaschwarz@gmail.com

ABSTRACT
Aim: Autologous fat grafting has gained acceptance as a technique to improve aesthetic outcomes in
breast reconstruction. The purpose of this study was to share our clinical experience using autologous
fat injection to correct contour deformities during breast reconstruction. Methods: A single
surgeon, prospectively maintained database of patients who underwent autologous fat injection
during breast reconstruction from January 2008 to November 2013 at McGill University Health
Center was reviewed. Patient characteristics, breast history, type of breast reconstruction, volume
of fat injected, and complications were analyzed. Results: One hundred and twenty-four patients
benefited from autologous fat injection from January 2008 to November 2013, for a total of 187
treated breasts. The patients were on average 49.3 years old (± 8.9 years). Fat was harvested from
the medial thighs (20.5%), flanks (39.1%), medial thighs and flanks (2.9%), trochanters (13.3%),
medial knees (2.7%), and abdomen (21.9%). An average of 49.25 mL of fat was injected into
each reconstructed breast. A total of 187 breasts in 124 patients were lipo-infiltrated during the
second stage of breast reconstruction. Thirteen breasts (in 12 separate patients) were injected several
years after having undergone lumpectomy and radiotherapy. Of the 187 treated breasts, 118
were reconstructed with expanders to implants, 45 with deep inferior epigastric perforator flaps,
9 with latissimus dorsi flaps with implants, 4 with transverse rectus abdominis myocutaneous flaps,
and 13 had previously undergone lumpectomy and radiotherapy. Six complications were noted in
the entire series, for a rate of 3.2%. All were in previously radiated breasts. Average follow-up time
was 12 months (range: 2-36 months). Conclusion: Fat injection continues to grow in popularity
as an adjunct to breast reconstruction. Our experience demonstrates a low complication rate as
compared to most surgical interventions of the breast and further supports its safety in breast
reconstruction. However, caution should be used when treating previously radiated breasts.

Key words:
Breast, contour deformities, fat injection

Access this article online INTRODUCTION
Quick Response Code:
Website: Fat injection is a useful surgical modality to correct
www.parjournal.net
anatomic contour deformities. [1-3] In 1987, the American
Society of Plastic Surgeons published a report discouraging
DOI: the use of autologous fat injections in the breast due
10.4103/2347-9264.157103 to potential complications related to calcifications and
detection of breast cancer. Improvements and technique
[4]
Plast Aesthet Res || Vol 2 || Issue 3 || May 15, 2015 115