Autologous fat grafting (AFG) is a surgical technique in which a patient’s own fat is harvested using liposuction and transplanted elsewhere. High rates of fat necrosis and unpredictable volume loss dampened initial interest, compounded by concerns that AFG increases cancer recurrence[1-3] and masks new disease on surveillance imaging. This study therefore aims to determine whether the complication risks are no greater reported AFG complication rates, and to determine patient satisfaction of results.
The surgical database of a single tertiary referral centre was was searched for “patients discharged from the plastics surgery department between 1 August 2014 and 30 September 2016 coded with a fat graft” This search identified 25 eligible patients with an average age of 54 (range 23-76), of which 7 had their first AFG session before 2014 and 11 have ongoing treatment. Up to 4 AFG were needed to achieve results, with an average of 2.
1 patient developed an abscess from the abdominal incision for fat harvesting, requiring surgical incision and drainage. Cysts were the most common clinical and radiological finding at 33%. There were no reported large fat necroses. 1 of the 4 reported cysts required surgical excision. No patient had a new incidence or recurrence of breast cancer.
Documentation of aesthetic results was poor, with only 60% having clinician satisfaction documented. Clinician evaluation of results were either good or neutral, and patient satisfaction very good to good.
Complication rates were greater than known rates, although must be interpreted with caution due to small sample size. It is, however, reassuring that there were no new cases of breast cancer and that satisfaction was high amongst both patients and clinicians. There is currently a lack of standardised post-operative patient-reported outcome measure regarding AFG, and further research should focus on patient and clinician satisfaction.