BACKGROUND Autologous fat grafting is an effective tool for soft-tissue augmentation in reconstructive breast surgery. Despite major advantages of this minimally invasive approach, the unpredictability of graft survival is challenging.… Click to show full abstract
BACKGROUND Autologous fat grafting is an effective tool for soft-tissue augmentation in reconstructive breast surgery. Despite major advantages of this minimally invasive approach, the unpredictability of graft survival is challenging. OBJECTIVES No clear consensus on the optimal technique has been published yet and well-defined prospective studies investigating impairing factors are lacking. The present project aimed at generating valuable fundamental data. METHODS Ten female patients undergoing elective autologous fat grafting after nipple-sparing mastectomy were enrolled. Punch biopsies and lipoaspirates were collected from the harvest site for histological, gene expression and scanning electron microscopic analysis. Non-invasive Lipometer measurements determining the subcutaneous adipose tissue thickness at the graft site were used to calculate the respective take rate. Patient- and surgery-related data were acquired and correlated with the take rate. RESULTS A statistically relevant correlation between the take rate and the existing mean subcutaneous adipose tissue thickness at the grafted breast prior to surgery was observed. An approximate correlation was identified regarding the number of prior grafting sessions, body weight and BMI. No statistically significant correlation was demonstrated for the age, harvest site, or the mean adipocyte size. A lower level of cell damage was observed in scanning electron microscopic samples of washed lipoaspirates; and a strong indirect correlation was encountered with the expression of the adipocyte markers FABP4 and PLIN1. CONCLUSIONS We were able to identify factors correlating to the take rate. Future studies investigating the clinical relevance of each impairing factor determined are essential to contribute to the optimization of this valuable method.
               
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