Har-Shai Lior, Lagziel Tomer, Grubstein Ahuva, Shay Tamir, Ad-El Dean, Meshulam-Derazon Sagit, Sharon Eran, Icekson Michael
Department of Plastic Surgery and Burns, Rabin Medical Center, Beilinson Hospital, Petah Tikva, Israel.
Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel.
Aesthetic Plast Surg. 2025 Apr 7. doi: 10.1007/s00266-025-04790-3.
Fat grafting is a valuable tool for oncologic breast reconstruction, as it enhances aesthetic outcomes. However, concerns regarding oncologic safety and challenges in postoperative imaging have limited the adoption of immediate oncoplastic breast reconstruction (IOBR) with fat grafting. This approach can reduce the need for additional surgeries, shorten recovery time, improve aesthetics, and help mitigate the adverse effects of adjuvant radiation therapy. This study evaluates postoperative, radiological, aesthetic, and patient-reported outcomes of immediate fat grafting in oncoplastic breast reconstruction following lumpectomy.
We conducted a retrospective study of patients undergoing IOBR with immediate fat grafting following lumpectomy (2020-2022). The plastic surgery team performed reconstruction simultaneously with lumpectomy by breast surgeons. Patient satisfaction was assessed using the Breast-Q questionnaire, while expert surgeons evaluated aesthetic outcomes. Lesion characteristics, specimen weight, and postoperative radiation details were recorded. Postoperative breast imaging was reviewed for fat grafting-related abnormalities.
Fifteen patients were included, with 87% undergoing postoperative radiotherapy. No major complications or readmissions occurred within 30 days. Breast imaging follow-up showed 91.1% had benign post-surgical changes, while 8.9% required short-term radiologic follow-up. Post-lipoid injection findings appeared in 37.8% of cases, none with calcifications. Patient satisfaction was high (average Breast-Q Score was 74.5), with only one patient requesting additional fat grafting post-radiation. Expert assessments confirmed improved aesthetic outcomes.
IOBR with immediate fat grafting is a useful technique for lumpectomy defects across all breast quadrants, demonstrating low complication rates, high patient satisfaction, and positive aesthetic outcomes. Postoperative imaging follow-up revealed no adverse effects related to fat grafting, supporting its potential role as an additional tool in oncoplastic breast reconstruction.
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脂肪移植是肿瘤性乳房重建的一项重要手段，因为它能提升美学效果。然而，对肿瘤安全性的担忧以及术后影像学检查方面的挑战，限制了即刻肿瘤整形乳房重建（IOBR）联合脂肪移植的应用。这种方法可减少额外手术的需求，缩短恢复时间，改善美观度，并有助于减轻辅助放疗的不良反应。本研究评估了乳房肿块切除术后即刻脂肪移植在肿瘤整形乳房重建中的术后、放射学、美学及患者报告结局。
我们对2020年至2022年间接受乳房肿块切除术后即刻脂肪移植的IOBR患者进行了一项回顾性研究。整形手术团队与乳腺外科医生同时进行乳房肿块切除术和重建手术。使用乳房-Q问卷评估患者满意度，由专业外科医生评估美学效果。记录病变特征、标本重量和术后放疗细节。对术后乳房影像学检查进行复查，以查找与脂肪移植相关的异常情况。
纳入15例患者，其中87%接受了术后放疗。30天内未发生重大并发症或再次入院情况。乳房影像学随访显示，91.1%有良性术后改变，而8.9%需要短期放射学随访。37.8%的病例出现脂质注射后表现，均无钙化。患者满意度较高（乳房-Q平均评分为74.5），只有1例患者在放疗后要求进行额外的脂肪移植。专业评估证实美学效果有所改善。
乳房肿块切除术后即刻脂肪移植的IOBR是一种适用于所有象限乳房肿块切除缺损的有用技术，并发症发生率低，患者满意度高，美学效果良好。术后影像学随访未发现与脂肪移植相关的不良反应，支持其作为肿瘤整形乳房重建中一种额外工具的潜在作用。
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