Fat Grafting in After Breast Cancer Surgery

Rodrigo Arrangoiz MS, MD, FACS, FSSO
  • Autologous fat grafting:
    • Is a procedure to transfer fat from one part of the patient’s body to another without requiring microvascular anastomosis
    • The graft initially takes similar to a skin graft, depending on the surrounding tissue bed before new blood vessels form
    • The grafted tissue is at risk for ischemia or fat necrosis:
      • As a result, there may be both palpable changes (e.g., cyst) or radiographic changes (e.g., calcifications) following fat grafting:
        • These have benign appearance on mammogram and are generally distinguishable from malignancy but may prompt additional imaging
  • Retrospective data suggest fat grafting does not interfere with cancer screening or detection
  • Fat grafting can be performed for all types of reconstruction, including primary defects as in lumpectomy, asymmetry, contour changes after radiation, or contour irregularity over an implant or tissue flap:
    • To date, there have been no clinical studies that demonstrate an increase in local regional recurrence in patients who have undergone fat grafting after breast cancer treatment
  • There is debate as to whether there is an ideal time to perform fat grafting:
    • But it is not routinely performed at the same time as lumpectomy or mastectomy:
      • Especially if radiation is indicated, as the tissue grafts will be susceptible to radiation injury
  • Finally, graft resorption is possible following the procedure, and therefore patients should be counseled that more than one operation may be necessary to achieve the desired result
  • References
    • Khouri RK Jr, Khouri RK. Current clinical applications of fat grafting. Plast Reconstr Surg 2017;140(3):466e-486e.
    • Agha RA, Fowler AJ, Herlin C, Goodacre TE, Orgill DP. Use of autologous fat grafting for breast reconstruction: a systematic review with meta-analysis of oncological outcomes. J Plast Reconstr Aesthet Surg. 2015;68(2):143-161.
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Published by Rodrigo Arrangoiz MS, MD, FACS, FSSO

My name is Rodrigo Arrangoiz I am a breast surgeon/ thyroid surgeon / parathyroid surgeon / head and neck surgeon / surgical oncologist that works at Center for Advanced Surgical Oncology in Miami, Florida. I was trained as a surgeon at Michigan State University from (2005 to 2010) where I was a chief resident in 2010. My surgical oncology and head and neck training was performed at the Fox Chase Cancer Center in Philadelphia from 2010 to 2012. At the same time I underwent a masters in science (Clinical research for health professionals) at the University of Drexel. Through the International Federation of Head and Neck Societies / Memorial Sloan Kettering Cancer Center I performed a two year head and neck surgery and oncology / endocrine fellowship that ended in 2016. Mi nombre es Rodrigo Arrangoiz, soy cirujano oncólogo / cirujano de tumores de cabeza y cuello / cirujano endocrino que trabaja Center for Advanced Surgical Oncology en Miami, Florida. Fui entrenado como cirujano en Michigan State University (2005 a 2010 ) donde fui jefe de residentes en 2010. Mi formación en oncología quirúrgica y e n tumores de cabeza y cuello se realizó en el Fox Chase Cancer Center en Filadelfia de 2010 a 2012. Al mismo tiempo, me sometí a una maestría en ciencias (investigación clínica para profesionales de la salud) en la Universidad de Drexel. A través de la Federación Internacional de Sociedades de Cabeza y Cuello / Memorial Sloan Kettering Cancer Center realicé una sub especialidad en cirugía de cabeza y cuello / cirugia endocrina de dos años que terminó en 2016.

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