International Expert Panel Consensus on Fat Grafting of the Breast.


Journal

Plastic and reconstructive surgery. Global open
ISSN: 2169-7574
Titre abrégé: Plast Reconstr Surg Glob Open
Pays: United States
ID NLM: 101622231

Informations de publication

Date de publication:
Oct 2019
Historique:
received: 08 06 2019
accepted: 02 07 2019
entrez: 28 11 2019
pubmed: 28 11 2019
medline: 28 11 2019
Statut: epublish

Résumé

Autologous fat grafting has broad applications in reconstructive and aesthetic breast surgery as a natural filler and for its regenerative purposes. Despite the widespread use of fat grafting, there remains no shared consensus on what constitutes the optimal fat grafting technique and its oncological safety. For this reason, the authors of this study have organized a Survey and an International Consensus Conference that was held at the Aesthetic Breast Meeting in Milan (December 15, 2018). All studies on fat grafting, both for breast aesthetic and reconstructive purposes, were electronically screened. The literature review led to 17 "key questions" that were used for the Survey. The authors prepared a set of 10 "key statements" that have been discussed in a dedicated face-to-face session during the meeting. The 10 key statements addressed all the most debated topics on fat grafting of the breast. Levels of evidence for the key statements ranged from III to IV with 2 statements (20%) supported by a level of evidence III and 6 statements (60%) by level of evidence IV. Overall consensus was reached for 2 statements (20%) with >75% agreement reached for 7 statements. The survey demonstrated a diversity of opinion and attitude among the panelists with regard to technique. Clear recommendations for evidence-based clinical practice for fat grafting use both in aesthetic and reconstructive breast surgery could not be defined due to the scarcity of level 1 or 2 studies.

Sections du résumé

BACKGROUND BACKGROUND
Autologous fat grafting has broad applications in reconstructive and aesthetic breast surgery as a natural filler and for its regenerative purposes. Despite the widespread use of fat grafting, there remains no shared consensus on what constitutes the optimal fat grafting technique and its oncological safety. For this reason, the authors of this study have organized a Survey and an International Consensus Conference that was held at the Aesthetic Breast Meeting in Milan (December 15, 2018).
METHODS METHODS
All studies on fat grafting, both for breast aesthetic and reconstructive purposes, were electronically screened. The literature review led to 17 "key questions" that were used for the Survey. The authors prepared a set of 10 "key statements" that have been discussed in a dedicated face-to-face session during the meeting.
RESULTS RESULTS
The 10 key statements addressed all the most debated topics on fat grafting of the breast. Levels of evidence for the key statements ranged from III to IV with 2 statements (20%) supported by a level of evidence III and 6 statements (60%) by level of evidence IV. Overall consensus was reached for 2 statements (20%) with >75% agreement reached for 7 statements.
CONCLUSIONS CONCLUSIONS
The survey demonstrated a diversity of opinion and attitude among the panelists with regard to technique. Clear recommendations for evidence-based clinical practice for fat grafting use both in aesthetic and reconstructive breast surgery could not be defined due to the scarcity of level 1 or 2 studies.

Identifiants

pubmed: 31772879
doi: 10.1097/GOX.0000000000002426
pmc: PMC6846285
doi:

Types de publication

Journal Article

Langues

eng

Pagination

e2426

Informations de copyright

Copyright © 2019 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of The American Society of Plastic Surgeons.

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Auteurs

Maurizio B Nava (MB)

University of Milan, Milan, Italy.
G.RE.T.A. Group for Reconstructive and Therapeutic Advancements, Milan, Naples, Catania, Italy.

Phillip Blondeel (P)

Department of Plastic Surgery, University Hospital Gent, Belgium.

Giovanni Botti (G)

Villa Bella Clinic, Salò (Brescia), Italy.

Francesco Casabona (F)

Private Practice, Genova, Italy.

Giuseppe Catanuto (G)

G.RE.T.A. Group for Reconstructive and Therapeutic Advancements, Milan, Naples, Catania, Italy.
Multidisciplinary Breast Unit, Azienda Ospedaliera Cannizzaro, Catania, Italy.

Mark W Clemens (MW)

MD Anderson Cancer Centre, Houston, Tex.

Domenico De Fazio (D)

Private Practice, Italy.

Roy De Vita (R)

Department of Plastic Surgery National Cancer Institute "Regina Elena," Rome, Italy.

James Grotting (J)

Private Practice, Birmingham, Ala.

Dennis C Hammond (DC)

Partners in Plastic Surgery of West Michigan, Grand Rapids, Mich.

Paul Harris (P)

Private Practice, The London Clinic, London, United Kingdom.

Paolo Montemurro (P)

Akademikliniken, Stockholm, Sweden.

Alexandre Mendonça Munhoz (A)

Department of Plastic and Reconstructive Surgery, Sírio-Libanês Hospital, São Paulo, Brazil.

Maurice Nahabedian (M)

Department of Surgery, VCU - College of Medicine - Inova Branch, Falls Church, Va.

Stefano Pompei (S)

Chief of Plastic & Reconstructive Surgery Division, San Camillo General Hospital of Rome, Rome, Italy.

Alberto Rancati (A)

Chief Oncoplastic Surgery, Instituto Henry Moore, University of Buenos Aires, Buenos Aires, Argentina.

Gino Rigotti (G)

Clinica San Francesco, Verona, Italy.

Marzia Salgarello (M)

Department of Plastic and Reconstructive Surgery, University of the Sacred Heart of Rome, Policlinico Gemelli.

Gianfranco Scaperrotta (G)

Radiology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.

Andrea Spano (A)

The Clinic, Milan, Italy.

Costantin Stan (C)

S Clinic, Bucharest, Romania.

Nicola Rocco (N)

G.RE.T.A. Group for Reconstructive and Therapeutic Advancements, Milan, Naples, Catania, Italy.

Classifications MeSH