Autologous Fat Grafting for Post-Mastectomy Breast Reconstruction: A Literature Review

Abstract

Introduction: Autologous fat grafting has emerged as a valuable adjunctive technique in post-mastectomy breast reconstruction, offering improved contour and volume restoration. This literature review evaluates its efficacy, safety, and long-term outcomes.

Methods: A systematic search was conducted in PubMed, Scopus, and Web of Science using terms "autologous fat grafting," "breast reconstruction," and "fat necrosis." Inclusion criteria: English-language studies with ≥10 patients reporting outcomes after fat grafting for breast reconstruction. Data on complication rates, volume retention, and patient satisfaction were extracted.

Results: Forty-seven studies met inclusion criteria. Volume retention ranged from 60% to 80% at one year following the final procedure. Fat necrosis occurred in 12% of cases, oil cysts in 5%, and palpable nodules in 8%. No conclusive evidence linked fat grafting to increased local recurrence risk. Patient-reported satisfaction, measured by BREAST-Q, improved significantly across all domains.

Discussion: Autologous fat grafting provides natural-looking results with low morbidity. Limitations include technique variability, lack of standardized protocols, and the need for multiple sessions. The absence of increased recurrence risk is reassuring but requires long-term confirmation.

Conclusions: Autologous fat grafting is a safe and effective adjunct in breast reconstruction, yielding high patient satisfaction. Standardization of processing and injection techniques is recommended to minimize complications.