Page 22 - Delaware Medical Journal - January 2016
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CASE REVIEW
FIGURE 3
Preoperative right lateral oblique view (left) and postoperative view (right) of the patient following two fat grafting sessions from the medial thighs and hips, to the lower pole of the left breast. Photo shows one year postoperative result from first fat graft procedure and 8 months after the second procedure.
reconstruction would magnify the deformity, and had suggested a latissimus dorsi myocutaneous pedicled of the lower pole. The patient was unwilling to accept the scarring at the donor and recipient sites, postoperative drains, and the more lengthy recovery associated with such an invasive procedure. She was interested in a minimally-invasive option with a shorter postoperative recovery period.
The patient underwent two sessions of autologous fat grafting under general anesthesia, with fat removed from the medial thighs and hips, respectively.
The second session was performed four months following the initial treatment. The aspirated fat was processed using a telfa-adsorption technique, and reinjected in the lower pole of the left breast. Subcision release of the lumpectomy scar was performed concurrently.
DISCUSSION
Though initially controversial, the American Society of Plastic Surgery has deemed fat grafting to the breast
to be both safe and effective.8-10 What remains to be seen are the longevity
of these results, and the scope of the applicability of the technique. Advances further improve the results. However, these are still in the developmental stages at this point. Mammogram images following fat injection to the breast show fewer abnormalities than do images
after breast reduction, a widely accepted procedure.12 Patients and physicians should be aware of this technique, as it represents reconstructive problems.
The partial mastectomy/lumpectomy defect may include contour irregularities,
FIGURE 4
Preoperative anteroposterior closeup view (left) and postoperative view (right) of the patient following two fat grafting sessions from the medial thighs and hips, to the lower pole of the left breast. Photo shows one year postoperative result from first fat graft procedure and 8 months after the second procedure.
22 Del Med J | January 2016 | Vol. 88 | No. 1
