Comparable Outcomes for Exclusive Lipofilling and Lipofilling-Implant Combination in Breast Reconstruction: A Retrospective Cohort Study

Abstract

ABSTRACTBackgroundAutologous fat grafting combined with prosthesis placement has become a widely accepted standard for breast reconstruction. However, a growing trend toward exclusive lipofilling-based reconstruction (LBR) is emerging. In this retrospective study, we compared the surgical and cosmetic outcomes of LBR to combined breast reconstruction (CBR) using fat grafting in conjunction with prosthetic placement.MethodsThis single-center retrospective cohort study included 170 patients who underwent mastectomy between 2014 and 2018 and received either LBR or CBR. The surgical parameters and outcomes were compared between the two groups.Additionally, the cosmetic outcome was evaluated using a Likert-type ordinal scale by the patients, surgeon, and nurse.ResultsThe study included a total of 170 patients, with 91 patients receiving LBR and 79 patients receiving CBR in combination with prosthetic placement. Patients who received exclusive lipofilling had more sessions on average than those who received prosthetic placement (3.7 lipofilling sessions vs. 2.17 sessions). Additionally, the volume of injected fat was significantly higher in the lipofilling group. No reconstruction failures were reported in either group. Patient, surgeon, and nurse satisfaction scores were high, with an average score of 4.7/5, 4.8/5, and 4.8/5, respectively, at 24 months of follow-up.ConclusionIn this follow-up study, we demonstrate that exclusive lipofilling results in satisfactory cosmetic outcomes with a low rate of complications. This minimally invasive approach to breast reconstruction can serve as a viable alternative to flap and prosthetic-based reconstruction.