Is there an ideal donor site of fat for secondary breast reconstruction?

Abstract

Loss of volume after autologous fat transfer to the breast is well documented, and various methods to improve long-term survival of fat grafts have been investigated (including both distant and neighboring harvest sites), but no optimal technique has been identified. The authors compare fat graft survival from 2 anatomical donor sites to determine whether there is an optimal site for fat graft harvesting in breast reconstruction. Seventy-three patients (109 breasts) who received fat grafting to reconstructed breasts from 2009 to 2012 were enrolled in this retrospective study and divided into 2 groups: group A had fat harvested from the abdomen and group B from the thighs. Fat grafting was performed using a modified Coleman technique for symmetry. For all patients, 3-dimensional scans were obtained and volumes were analyzed. Forty-six patients (66 breasts) received an average of 101 mL of fat injected from the abdomen, and 27 (43 breasts) received an average of 102 mL from the thighs. Group A had 82% volume retention at 16 days, 63% at 49 days, and 45% at 140 days. Group B had 86% at 16 days, 63% at 49 days, and 46% at 140 days (P > .05). Patients were also stratified by radiation exposure and volume injected; neither affected donor site volume retention (P > .05). Our data suggest that donor site, regardless of volume injected or tissue radiation, did not affect volume retention in fat grafting. Longer-term studies are needed to assess the stability of the breast after fat grafting.