The Safety of Fat Grafting: An Institutional Retrospective Review.
Journal
Annals of plastic surgery
ISSN: 1536-3708
Titre abrégé: Ann Plast Surg
Pays: United States
ID NLM: 7805336
Informations de publication
Date de publication:
01 06 2022
01 06 2022
Historique:
entrez:
12
6
2022
pubmed:
13
6
2022
medline:
15
6
2022
Statut:
ppublish
Résumé
Autologous fat grafting is a popular technique for volume replacement in the breast and face. The efficacy, safety, and complication rate of this technique at the division of plastic surgery at the University of Alabama at Birmingham will be described in this review. An institutional review board-approved retrospective review of patients undergoing fat grafting procedures from January 2015 to July 2018 was performed. Records were reviewed for fat graft recipient site, donor site, amount grafted, and complications. Continuous variables were compared using either a t test or one-way analysis of variance test. Categorical data were compared using χ2 test. A P value of 0.05 or less was considered statistically significant for all comparisons. A total of 396 patients who underwent fat grafting procedures of the face and body from January 2015 through July 2018 met inclusion criteria. Average amount of fat grafted for all grafts was 124.4 +/- 6.74 grams. Two hundred fifty of the grafts (62.7%) involved the bilateral breasts with an average of 140.6 +/- 93.97 g used, 70 per side. Of the 396 patients, 110 (27.8%) experienced complications. Forty three of the complications (10.9%) were considered to be major, which included hematomas/seromas, fat necrosis, dermatitis/cellulitis, and infection. No statistical differences were seen among recipient site complication rate. Types of minor complications were statistically significant per recipient sites with bilateral breasts more likely to experience asymmetry than the other recipient sites (20% for bilateral breasts vs 16% overall, P < 0.05). Fifty nine of the 110 patients (53.6%) had the complications reported to be resolved. Fat grafting is a reliable method for volumization of the breasts and face. Minor complications were not infrequent in this case series; however, no life-threatening complications were observed. Continued work needs to be done to use fat grafting beyond traditional measures.
Sections du résumé
BACKGROUND
Autologous fat grafting is a popular technique for volume replacement in the breast and face. The efficacy, safety, and complication rate of this technique at the division of plastic surgery at the University of Alabama at Birmingham will be described in this review.
METHODS
An institutional review board-approved retrospective review of patients undergoing fat grafting procedures from January 2015 to July 2018 was performed. Records were reviewed for fat graft recipient site, donor site, amount grafted, and complications. Continuous variables were compared using either a t test or one-way analysis of variance test. Categorical data were compared using χ2 test. A P value of 0.05 or less was considered statistically significant for all comparisons.
RESULTS
A total of 396 patients who underwent fat grafting procedures of the face and body from January 2015 through July 2018 met inclusion criteria. Average amount of fat grafted for all grafts was 124.4 +/- 6.74 grams. Two hundred fifty of the grafts (62.7%) involved the bilateral breasts with an average of 140.6 +/- 93.97 g used, 70 per side. Of the 396 patients, 110 (27.8%) experienced complications. Forty three of the complications (10.9%) were considered to be major, which included hematomas/seromas, fat necrosis, dermatitis/cellulitis, and infection. No statistical differences were seen among recipient site complication rate. Types of minor complications were statistically significant per recipient sites with bilateral breasts more likely to experience asymmetry than the other recipient sites (20% for bilateral breasts vs 16% overall, P < 0.05). Fifty nine of the 110 patients (53.6%) had the complications reported to be resolved.
CONCLUSIONS
Fat grafting is a reliable method for volumization of the breasts and face. Minor complications were not infrequent in this case series; however, no life-threatening complications were observed. Continued work needs to be done to use fat grafting beyond traditional measures.
Identifiants
pubmed: 35690941
doi: 10.1097/SAP.0000000000003234
pii: 00000637-202206005-00015
pmc: PMC9893916
mid: NIHMS1863800
doi:
Types de publication
Journal Article
Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
S473-S477Subventions
Organisme : NCATS NIH HHS
ID : TL1 TR003106
Pays : United States
Organisme : NCATS NIH HHS
ID : UL1 TR003096
Pays : United States
Informations de copyright
Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.
Déclaration de conflit d'intérêts
Conflicts of interest and sources of funding: This article was funded in part by the National Center for Advancing Translational Sciences of the National Institutes of Health under award number UL1TR003096.
Références
Largo RD, Tchang LA, Mele V, et al. Efficacy, safety and complications of autologous fat grafting to healthy breast tissue: a systematic review. J Plast Reconstr Aesthet Surg . 2014;67:437–448.
Marten TJ, Elyassnia D. Fat grafting in facial rejuvenation. Clin Plast Surg . 2015;42:219–252.
Krastev TK, Alshaikh GAH, Hommes J, et al. Efficacy of autologous fat transfer for the correction of contour deformities in the breast: a systematic review and meta-analysis. J Plast Reconstr Aesthet Surg . 2018;71:1392–1409.
Spear SL, Coles CN, Leung BK, et al. The safety, effectiveness, and efficiency of autologous fat grafting in breast surgery. Plast Reconstr Surg Glob Open . 2016;4:e827.
Le JM, Bosworth JW, Honeywell B, et al. Adipose grafting for volume and scar release. Ann Plast Surg . 2021;86:S487–S490.
Agha RA, Pidgeon TE, Borrelli MR, et al. Validated outcomes in the grafting of autologous fat to the breast: the VOGUE study. Development of a core outcome set for research and audit. Plast Reconstr Surg . 2018;141:633e–638e.
Groen JW, Negenborn VL, Twisk JW, et al. Autologous fat grafting in cosmetic breast augmentation: a systematic review on radiological safety, complications, volume retention, and patient/surgeon satisfaction. Aesthet Surg J . 2016;36:993–1007.
Condé-Green A, Kotamarti V, Nini KT, et al. Fat grafting for gluteal augmentation: a systematic review of the literature and meta-analysis. Plast Reconstr Surg . 2016;138:437e–446e.
Al Sufyani MA, Al Hargan AH, Al Shammari NA, et al. Autologous fat transfer for breast augmentation: a review. Dermatol Surg . 2016;42:1235–1242.
Lu Z, Yuan Y, Gao J, et al. Adipose tissue extract promotes adipose tissue regeneration in an adipose tissue engineering chamber model. Cell Tissue Res . 2016;364:289–298.
Toyserkani NM, Jensen CH, Tabatabaeifar S, et al. Adipose-derived regenerative cells and fat grafting for treating breast cancer-related lymphedema: lymphoscintigraphic evaluation with 1 year of follow-up. J Plast Reconstr Aesthet Surg . 2019;72:71–77.
Jones IA, Wilson M, Togashi R, et al. A randomized, controlled study to evaluate the efficacy of intra-articular, autologous adipose tissue injections for the treatment of mild-to-moderate knee osteoarthritis compared to hyaluronic acid: a study protocol. BMC Musculoskelet Disord . 2018;19:383.
Jan SN, Bashir MM, Khan FA, et al. Unfiltered nanofat injections rejuvenate postburn scars of face. Ann Plast Surg . 2019;82:28–33.
Tarallo M, Fino P, Ribuffo D, et al. Liposuction aspirate fluid adipose-derived stem cell injection and secondary healing in fingertip injury: a pilot study. Plast Reconstr Surg . 2018;142:136–147.
Schendel SA. Enriched autologous facial fat grafts in aesthetic surgery: 3D volumetric results. Aesthet Surg J . 2015;35:913–919.
Zhu M, Xie Y, Zhu Y, et al. A novel noninvasive three-dimensional volumetric analysis for fat-graft survival in facial recontouring using the 3L and 3M technique. J Plast Reconstr Aesthet Surg . 2016;69:248–254.
Park S, Kim B, Shin Y. Correction of superior sulcus deformity with orbital fat anatomic repositioning and fat graft applied to retro-orbicularis oculi fat for Asian eyelids. Aesthetic Plast Surg . 2011;35:162–170.
Lin JY, Song P, Pu LLQ. Reply: management of fat necrosis after autologous fat transplantation for breast augmentation. Plast Reconstr Surg . 2019;144:701e–702e.
Jung HK, Kim CH, Song SY. Prospective 1-year follow-up study of breast augmentation by cell-assisted lipotransfer. Aesthet Surg J . 2016;36:179–190.
Gerth DJ, King B, Rabach L, et al. Long-term volumetric retention of autologous fat grafting processed with closed-membrane filtration. Aesthet Surg J . 2014;34:985–994.
Guibert M, Franchi G, Ansari E, et al. Fat graft transfer in children's facial malformations: a prospective three-dimensional evaluation. J Plast Reconstr Aesthet Surg . 2013;66:799–804.
Sinno S, Chang JB, Brownstone ND, et al. Determining the safety and efficacy of gluteal augmentation: a systematic review of outcomes and complications. Plast Reconstr Surg . 2016;137:1151–1156.
Cuzalina A, Guerrero AV. Complications in fat grafting. Atlas Oral Maxillofac Surg Clin North Am . 2018;26:77–80.
Lazzeri D, Agostini T, Figus M, et al. Blindness following cosmetic injections of the face. Plast Reconstr Surg . 2012;129:995–1012.
Oranges CM, Tremp M, di Summa PG, et al. Gluteal augmentation techniques: a comprehensive literature review. Aesthet Surg J . 2017;37:560–569.
Ørholt M, Larsen A, Hemmingsen MN, et al. Complications after breast augmentation with fat grafting: a systematic review. Plast Reconstr Surg . 2020;145:530e–537e.
Simonacci F, Bertozzi N, Grieco MP, et al. Procedure, applications, and outcomes of autologous fat grafting. Ann Med Surg (Lond) . 2017;20:49–60.
Challapalli RS, Dwyer RM, McInerney N, et al. Effect of breast cancer and adjuvant therapy on adipose-derived stromal cells: implications for the role of ADSCs in regenerative strategies for breast reconstruction. Stem Cell Rev Rep . 2021;17:523–538.
Bielli A, Scioli MG, Gentile P, et al. Adult adipose-derived stem cells and breast cancer: a controversial relationship. Springerplus . 2014;3:345.
De Decker M, De Schrijver L, Thiessen F, et al. Breast cancer and fat grafting: efficacy, safety and complications—a systematic review. Eur J Obstet Gynecol Reprod Biol . 2016;207:100–108.
Wu R, Yang X, Jin X, et al. Three-dimensional volumetric analysis of 3 fat-processing techniques for facial fat grafting: a randomized clinical trial. JAMA Facial Plast Surg . 2018;20:222–229.
Cristel RT, Caughlin BP. Lower blepharoplasty three-dimensional volume assessment after fat pad transposition and concomitant fat grafting. Facial Plast Surg . 2020;36:478–483.