Mashiko Takanobu, Hattori Yoshitsugu, Horiguchi Yoko, Inoue Mai
From the Department of Plastic Surgery, Kanto Central Hospital of the Mutual Aid Association of Public School Teachers, Tokyo, Japan.
Plast Reconstr Surg Glob Open. 2025 Jun 12;13(6):e6866. doi: 10.1097/GOX.0000000000006866. eCollection 2025 Jun.
This study aimed to evaluate the impact of secondary fat grafting on patient satisfaction and well-being using the BREAST-Q, in patients who underwent flap- or implant-based breast reconstruction.
The patients who underwent postmastectomy breast reconstruction were divided into 4 groups based on the reconstruction technique: flap followed by fat grafting (Flap-FG), flap alone (Flap-only), implant followed by fat grafting (Imp-FG), and implant alone (Imp-only). Secondary fat grafting was performed for those dissatisfied with their initial reconstruction. One year postoperation, patients completed the BREAST-Q questionnaire, assessing breast satisfaction, outcome satisfaction, psychosocial well-being, and sexual well-being, with scores ranging from 0 to 100.
Of the 162 patients, 139 responded to the questionnaire (response rate: 85.8%), including 14 in the Flap-FG group, 38 in the Flap-only group, 23 in the Imp-FG group, and 64 in the Imp-only group. Secondary fat grafting improved scores in both flap- and implant-reconstructed breasts, with the Imp-FG group showing significant improvements in all domains compared with the Imp-only group, including breast satisfaction ( = 0.007), outcome satisfaction ( = 0.041), psychosocial well-being ( < 0.001), and sexual well-being ( < 0.001). The Flap-FG group showed significant improvement only in outcome satisfaction ( = 0.020) compared with the Flap-only group. The Flap-only group had higher breast satisfaction scores than the Imp-only group ( = 0.049), whereas the Imp-FG group had better psychosocial and sexual well-being scores than the Flap-FG group.
Secondary fat grafting is highly useful in improving patient satisfaction by correcting breast shape, size, and deformities in cases where dissatisfaction exists with the initial breast reconstruction.
本研究旨在使用BREAST-Q评估二次脂肪移植对接受皮瓣或植入物乳房重建患者的满意度和生活质量的影响。
接受乳房切除术后乳房重建的患者根据重建技术分为4组：皮瓣后脂肪移植（皮瓣-脂肪移植组）、单纯皮瓣组、植入物后脂肪移植（植入物-脂肪移植组）和单纯植入物组。对初次重建不满意的患者进行二次脂肪移植。术后1年，患者完成BREAST-Q问卷，评估乳房满意度、结果满意度、心理社会生活质量和性健康状况，分数范围为0至100。
162例患者中，139例回复了问卷（回复率：85.8%），包括皮瓣-脂肪移植组14例、单纯皮瓣组38例、植入物-脂肪移植组23例和单纯植入物组64例。二次脂肪移植提高了皮瓣和植入物重建乳房的得分，植入物-脂肪移植组与单纯植入物组相比，在所有领域均有显著改善，包括乳房满意度（P = 0.007）、结果满意度（P = 0.041）、心理社会生活质量（P < 0.001）和性健康状况（P < 0.001）。皮瓣-脂肪移植组与单纯皮瓣组相比，仅在结果满意度方面有显著改善（P = 0.020）。单纯皮瓣组的乳房满意度得分高于单纯植入物组（P = 0.049），而植入物-脂肪移植组的心理社会和性健康状况得分优于皮瓣-脂肪移植组。
在对初次乳房重建不满意的情况下，二次脂肪移植对于通过矫正乳房形状、大小和畸形来提高患者满意度非常有用。
