A Dutch study found high patient satisfaction and low complication rates with a staged reconstruction approach using a patient’s own fat.
Breast reconstruction using only a patient’s own fat may offer another viable option for women following mastectomy, particularly those who decline implants or are not candidates for flap surgery, according to a study published in Plastic and Reconstructive Surgery, the official medical journal of the American Society of Plastic Surgeons.
The study, led by researchers at Maastricht University Hospital in the Netherlands, evaluated a staged autologous fat transfer protocol and reported high patient satisfaction, meaningful quality-of-life improvements, and a low complication rate.
“There are still going to be patients that are going to go for the implant,” says lead author Andrzej A. Piatkowski de Grzymala, MD, PhD, a professor at Maastricht University Hospital, in a release. “There are still going to be patients wanting flap surgery, and there are going to be patients going for the autologous fat transfer. I think that is a good coexistence because there’s no perfect reconstruction for patients.”
A Staged Reconstruction Protocol
The reconstruction process occurs in stages. Patients first use a device called the EVE-bra to stretch the skin on the chest wall following mastectomy. They then undergo autologous fat transfer, in which fat is harvested via liposuction from donor sites such as the abdomen, back, hips, or thighs, processed, and injected into the chest to rebuild the breast.
Most patients required approximately four sessions to achieve their desired results.
Patient-Reported Outcomes
At one-year follow-up, patients reported significant improvements across several quality-of-life measures, including psychosocial, sexual, and physical well-being, as well as satisfaction with their breasts. Patients also reported improved body satisfaction, attributing the added benefit to the body contouring achieved through liposuction at donor sites.
According to Piatkowski, the reconstructed breast retains characteristics that implants cannot replicate. “It feels warm,” he says in a release. “What is even more interesting is some breast sensation comes back over time, and you will never achieve this with an implant.”
The authors concluded that the treatment is a safe and effective breast reconstruction option with a low complication rate.
Trade-Offs and Considerations
The protocol is not without drawbacks. Some patients described the process as burdensome and intense, with the full course taking approximately one year to complete. The EVE-bra device can also cause discomfort, skin irritation, blisters, and itching.
“What we hear from our patients is that it’s a long journey,” says Piatkowski in a release. “But in the end, and we saw that when we asked our patients after a long time, they’re very, very happy and they’re very positive about their results.”
The findings may expand the reconstructive conversation beyond implants and flap surgery for patients considering options after mastectomy, positioning autologous fat transfer as a potentially valuable additional approach.
