Evaluation of effects of autologous fat grafting on aesthetic outcomes in breast reconstruction following mastectomy: Effects of reconstruction type and prior radiotherapy exposure.

Early human evidence such as case series or small samples is exploring possible benefits.

• Level A · Stronger Clinical Evidence
• Level B · Emerging clinical evidence with positive signals
• Level C · Early human research exploring benefits
• Level D · Scientific groundwork from lab and animal studies
• Emerging · Emerging topic under active research

Abstract (original English)

Autologous fat grafting improves breast reconstruction aesthetics, yet impact relative to natural post-reconstructive changes remains poorly characterized. Retrospective analysis of 92 reconstructions (42 fat-grafted, 50 non-grafted) using BCCT.core and Harvard Scale assessments at 6-12 months. Non-grafted reconstructions demonstrated significant deterioration (46%; BCCT.core p = 0.027, Harvard p < 0.001) uniformly across modalities. Conventional 3-week radiotherapy produced greater deterioration than 5-day regimens ( p = 0.036, p = 0.024). Fat grafting reversed this trajectory, achieving 88.1% versus 4% complete complaint resolution (Mann-Whitney p < 0.001; effect sizes 0.41-0.84) across all reconstruction types and radiotherapy exposures. Irradiated reconstructions demonstrated greatest gains. One to two sessions typically sufficed. Post-reconstructive deterioration should be anticipated. Fat grafting functions as regenerative intervention modifying biological maturation. Findings support proactive staged incorporation into algorithms, particularly for irradiated patients.

Evidence level

Early human evidence such as case series or small samples is exploring possible benefits.

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