Quality of life after autologous fat transfer additional to prosthetic breast reconstruction in women after breast surgery: A systematic review

Eur J Surg Oncol. 2021 Apr;47(4):772-777. doi: 10.1016/j.ejso.2020.10.021. Epub 2020 Nov 4.


Background: Breast cancer is the most frequent form of cancer among women worldwide. Reconstructive surgery may improve the quality of life (QoL), after mastectomy. Various techniques are used to reconstruct the female breast; however, few is known about its specific post-surgery influence represented in patient-reported outcomes.

Objective: This systematic review assesses the difference in patient-reported QoL between prosthetic reconstruction alone, and prosthetic reconstruction with additional autologous fat transfer (AFT).

Data sources: A literature search was performed in PubMed, Embase, Cochrane and CINAHL online databases from inception to February 11th, 2020.

Study selection: Inclusion and exclusion criteria were used to assess the eligibility of the retrieved articles. The only eligible studies were cohort studies.

Data collection and analysis: Relevant data for the research question was extracted from the articles and systematically documented. Results not contributing to answering the objective were intentionally left out. No meta-analysis was realized.

Results: This systematic review resulted in the inclusion of only six relevant studies, all cohort studies, consisting of 1437 unique patients. These studies evaluated the quality of life of patients by means of the validated BREAST-Q questionnaire. Outcomes varied for which reason no definite answer could be provided to whether additional AFT results in a higher QoL.

Conclusions: It is unclear whether additional AFT after prosthetic surgery leads to a higher QoL when compared to sole prosthetic reconstruction or not. Additional studies, assessing the QoL of patients who received additional AFT, are required to draw solid conclusions.

Level of evidence: Level III; systematic literature review of cohort studies.

Keywords: Autologous fat transfer; Breast reconstruction; Lipofilling; Prosthetic breast surgery; Quality of life; Reconstructive surgery.

Publication types

  • Systematic Review

MeSH terms

  • Adipose Tissue / transplantation*
  • Autografts
  • Breast Implantation*
  • Breast Neoplasms / surgery*
  • Female
  • Humans
  • Mammaplasty / methods*
  • Mastectomy
  • Patient Reported Outcome Measures
  • Quality of Life*