Fat Grafting Improves Long-Term Outcomes in Post-Mastectomy Breast Reconstruction with Implants
A recent study conducted by the Plastic Surgery team at Sant’Anna Hospital, part of Asst Lariana, demonstrates the meaningful benefits of autologous fat grafting (lipofilling) in improving the longevity and reducing complications of breast reconstruction using implants, notably following radiotherapy. Published in the Journal of Clinical Medicine (impact factor 3.3),the research,lead by Dr. Alessia De Col and Dr.Francesco Buttarelli, followed 32 women who underwent two-stage prosthetic reconstruction after both oncological surgery and radiation therapy between 2010 and 2021.
The study focused on the impact of at least one lipofilling session – a procedure involving the removal and re-introduction of a patient’s own fat to enhance tissue quality – on long-term outcomes. After an average follow-up period of 7.7 years, researchers observed a capsular contracture rate of just 18.8%, with no instances of severe contracture. Importantly, no oncological recurrences were detected during the study period. All patients retained their original implants, reporting high levels of satisfaction with the softness and aesthetic results achieved.
“Our findings confirm that lipofilling is a safe and effective strategy for maintaining prosthetic breast reconstruction in patients who have undergone radiotherapy,” explains Dr. Anna Scevola, Head of Plastic Surgery at Sant’Anna Hospital. “In this long-term series, fat grafting was associated with a lower incidence of capsular contracture compared to previously reported data, and crucially, no serious contractures or oncological events occurred. For carefully selected patients who are not candidates for autologous reconstruction, lipofilling offers a valuable option to preserve implant viability, improve tissue quality, and minimize the need for further surgical intervention.”
The Asst Lariana Plastic Surgery department, under Dr. Scevola’s direction,has also recently presented innovative work at both the Italian Congress of Microsurgery and the National Congress of Plastic and Reconstructive Surgery (Sicpre). Presentations highlighted the team’s expertise in reconstructing bone loss in limbs using vascularized fibula flaps – a complex but highly effective technique for restoring limb functionality after trauma or cancer surgery.
Dr. Melissa Akuma, a specialist from the university of Naples Federico II currently training at Sant’anna, also contributed to the national congress, focusing on the frequently enough-underestimated issue of chronic neuropathic breast pain following mastectomy and axillary surgery.”Understanding the characteristics and causes of this post-surgical pain is crucial for developing more effective prevention and treatment strategies,” Dr. Scevola emphasized.
This dual recognition underscores the growing national prominence of the Como facility’s clinical and research contributions to the field of plastic and reconstructive surgery.
(For further information, please refer to the original article in the Journal of clinical Medicine: ”Long-Term Outcome in Implant Breast reconstruction and Radiotherapy: The Role of Fat Grafting” by Alessia de Col, Francesco Buttarelli, Melissa Akuma, Ferruccio Paganini and Anna Scevola: https://www.mdpi.com/2079-4991/13/2/241)