LAUSR

Background Stromal vascular fraction (SVF) and fat grafting are emerging alternatives to implants for breast augmentation. However, the lack of controlled clinical data has led to conflicting results regarding the effectiveness of surgical treatments. This study aimed to identify the key factors affecting the outcomes of fat grafting with SVF and to recognize novel methods to improve the retention rate. Patients and Methods In total, 384 women underwent breast augmentation using fat grafting with SVF. The patients were preoperatively and postoperatively managed and recalled for follow-up at 3, 6, and 18 months. Results The average volume of the injection in the left breast was 162.35 mL (range, 50–260 mL). The postoperative retention rates were 78.65% in 384 patients at 3 months, 77.17% in 273 patients at 6 months, and 77.48% in 102 patients at 18 months. The retention rates were compared based on the number of SVF cells; patients with more than 60 million cells had a retention rate of 70.77%, and those with less than 60 million cells had a retention rate of 85.60% at 18 months. The retention rates at the 18-month follow-up were 65.62% and 85.09% in stiff and soft breasts, respectively. A higher number of cells in the SVF was associated with a greater retention volume, and the retention volume was greater in patients with soft breasts. Given the higher use of the right arm, after 18 months of the surgery, the retention rate of the right breast (60.35%) was lower than that of the left breast (77.48%) (P < 0.05; t = −13.199). Conclusions Limiting arm movement, increasing the number of cells in the SVF, and improving the skin tension might enhance the retention rate in patients undergoing breast augmentation.