A combination of fat grafting with inferior dermal flap in breast reconstruction following prophylactic mastectomy: A cohort study
Language English Country Netherlands Media print-electronic
Document type Journal Article
PubMed
40154116
DOI
10.1016/j.bjps.2025.03.020
PII: S1748-6815(25)00191-3
Knihovny.cz E-resources
- Keywords
- Breast Reconstruction, Complications in Breast Surgery, Fat Grafting, Inferior Dermal Flap, Minimal Invasive Surgery, Prophylactic Mastectomy,
- MeSH
- Surgical Flaps * MeSH
- Adult MeSH
- Esthetics MeSH
- Cohort Studies MeSH
- Middle Aged MeSH
- Humans MeSH
- Mammaplasty * methods MeSH
- Breast Neoplasms * prevention & control surgery MeSH
- Prophylactic Mastectomy * MeSH
- Breast surgery pathology MeSH
- Surveys and Questionnaires MeSH
- Retrospective Studies MeSH
- Aged MeSH
- Patient Satisfaction MeSH
- Adipose Tissue * transplantation MeSH
- Treatment Outcome MeSH
- Check Tag
- Adult MeSH
- Middle Aged MeSH
- Humans MeSH
- Aged MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
BACKGROUND: Breast reconstruction following prophylactic mastectomy in women with ptotic or hypertrophic breasts often poses challenges. We describe a combined technique of large-volume fat grafting (>100 mL) and an inferior dermal flap, aiming to improve aesthetic outcomes and patient satisfaction. METHODS: We conducted a retrospective analysis of 21 patients undergoing immediate breast reconstruction with the described technique. All patients were asked to complete the BREAST-Q questionnaire preoperatively and at least 12 months postoperatively (median interval: 20 months). Statistical analysis (Wilcoxon signed-rank test) was used to assess changes in satisfaction and well-being; aesthetic outcomes were scored by an independent, multidisciplinary team. RESULTS: Among 13 patients with complete BREAST-Q data, satisfaction with the breasts increased significantly from a median score of 38-85 (p = 0.002), psychosocial well-being from 57-70 (p = 0.045), and physical well-being (chest) from 68 to 81 (p = 0.045). Sexual well-being rose from 47-63 (p = 0.023). Aesthetic evaluation by an independent panel showed notable improvements in breast symmetry, shape, and overall appearance. Minimal and asymptomatic fat necroses or oil liponecrotic pseudocysts were observed. CONCLUSIONS: Combining large-volume fat grafting with an inferior dermal flap appears promising for women with ptotic breasts, yielding high satisfaction and low complication rates. Despite requiring multiple operative stages, this autologous reconstruction technique may offer a less invasive alternative for high-risk patients seeking natural outcomes without implants.
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