Fat Grafting May Lead to Better Outcomes in Postmastectomy Breast Reconstruction

For patients who undergo postmastectomy breast reconstruction, fat grafting may benefit psychosocial well-being, sexual well-being, and breast satisfaction, according to a study published in JAMA Surgery.

Fat grafting has allowed plastic surgeons to improve the aesthetic outcomes for the treatment of irregularities and volume deficits, but the US Food and Drug Administration (FDA) has proposed regulations which may limit autologous fat grafting in a clinical setting. The study authors hope to observe the relationship between patient-reported outcomes (PRO) and fat grafting to provide supporting evidence for its use in breast reconstruction.

The Mastectomy Reconstruction Outcomes Consortium (MROC) Study enrolled 2048 patients, 165 of whom underwent fat grafting. The BREAST-Q survey was used to evaluate and compare PROs between patients who underwent fat grafting between years 1 and 2 and those who did not. The primary end points were PROs as measured by the BREAST-Q survey.

Significantly lower breast satisfaction scores (adjusted mean difference [AMD], –4.74; 95% CI, –8.21 to –1.28; P =.008), psychosocial well-being (AMD, –3.87; 95% CI, –7.33 to –0.04; P =.03), and sexual well-being (AMD, –5.59; 95% CI, –9.70 to –1.47; P =.008) were reported one year postoperatively by patients who underwent fat grafting compared to those who did not.

By year 2, there were no significant differences between the PROs of patients who received fat grafting for breast satisfaction (AMD, –0.68; 95% CI, –4.42 to 3.06; P =.72), psychosocial well-being (AMD, –0.59; 95% CI, –3.92 to 2.74; P =.73), and sexual well-being (AMD, –2.94; 95% CI, –7.01 to 1.12; P =.15), and those who did not.

The conclusions of the study demonstrate that there are no significant PRO differences between women who receive or do not receive fat grafting. The study authors conclude by saying that “fat grafting is an important tool in breast reconstruction and that this option should remain available to reconstructive surgeons and to the patients they serve.”