Improved patient-reported outcomes after autologous fat transplantation and corrective surgery after breast surgery

J Plast Surg Hand Surg. 2019 Apr;53(2):111-118. doi: 10.1080/2000656X.2018.1561456. Epub 2019 Jan 17.


Background: Autologous fat transplantation (AFT) is being increasingly used to improve the results after breast-conserving surgery and breast reconstruction. However, studies on patient-reported outcomes (PROs) and health-related quality of life (HRQoL) after AFT are scarce. The aim of this prospective longitudinal case-series study was to assess PRO in women who had undergone AFT after surgery for breast cancer or risk-reducing mastectomy.

Methods: Fifty women, who had undergone breast-conserving surgery or breast reconstruction, needing corrective surgery, were consecutively included between 2008 and 2013. A 20-item study-specific questionnaire (SSQ) and the Short Form Health Survey (SF-36) were used pre-operatively and 6 months, 1 year and 2 years post-operatively, to evaluate PRO and HRQoL.

Results: The patients underwent three (1-4) AFT procedures, with the injection of 164 ml (median) (range 40-516) fat. Thirty-eight and 34 patients completed the study-specific questionnaire and the SF-36, respectively, both pre-operatively and after 2 years. Sixteen of the 20 items in the SSQ were improved after 2 years, including breast size (p < 0.0001), shape (p < 0.0001), appearance (p < 0.0001), softness of the breast (p = 0.001), pain in the region (p = 0.005), scarring from previous breast surgery (p < 0.001) and willingness to participate in public physical activities (p < 0.001). HRQoL did not largely differ before and after AFT, or between the study group and a reference population.

Conclusions: AFT alone or in combination with other corrective surgical procedures, improved PRO after breast-conserving surgery and breast reconstruction in both irradiated and non-irradiated women.

Keywords: Quality of life; autologous fat transplantation; breast reconstruction; breast surgery; fat grafting; lipofilling; patient-reported outcome.

MeSH terms

  • Adipose Tissue / transplantation*
  • Adult
  • Aged
  • Female
  • Humans
  • Longitudinal Studies
  • Mammaplasty*
  • Mastectomy, Segmental*
  • Middle Aged
  • Patient Reported Outcome Measures*
  • Prospective Studies
  • Quality of Life*
  • Surveys and Questionnaires
  • Sweden
  • Transplantation, Autologous