Hae Kyoung Jung1, Chung Hun Kim1, Seung Yong Song1. 1. Dr Jung is an Associate Professor, Department of Radiology, and Dr Kim is a Professor, Department of Plastic and Reconstructive Surgery, CHA Bundang Medical Center, CHA University School of Medicine, Gyeonggi-do, Republic of Korea. Dr Song is an Assistant Professor, Department of Plastic and Reconstructive Surgery, Yonsei University College of Medicine, Seoul, Republic of Korea.
Abstract
BACKGROUND: Breast augmentation by cell-assisted lipotransfer (CAL) may achieve a more natural breast contour than silicone implants. Moreover, certain complications associated with these prosthetic devices can be avoided with CAL. Few prospective studies of CAL have been performed to examine long-term volume changes, effects on breast parenchymal tissue, and the effect of stromal vascular fraction (SVF) on graft survival. OBJECTIVES: In a 1-year prospective study of patients who underwent CAL, the authors examined changes in breast volume, effects on parenchymal tissue, and the impact of SVF on graft survival. METHODS: Following preoperative radiologic examination, patients underwent primary augmentation mammaplasty by CAL to both breasts. The SVF was characterized, and changes in breast volume were determined from magnetic resonance imaging studies performed postoperatively at 3 months and 1 year. A breast-imaging specialist reviewed all scans to detect changes in breasts. RESULTS: Five patients (10 breasts) were enrolled. Averagely 23% of grafted fat in volume was additionally harvested from each patient to isolate SVF cells. One year after CAL, breast volume had decreased to 47% of the initial postoperative volume. There was no parenchymal changes except small oil cysts. The ratio of SVF cell count to grafted fat volume showed no correlation with graft survival. Patterns of breast-volume decrease differed between older women with a history of breastfeeding and younger women without a history of breastfeeding. CONCLUSIONS: The addition of SVF cells did not appear to improve the retention of grafted fat in these patients. Skin tension may be an important factor influencing the absorption pattern of grafted fat. LEVEL OF EVIDENCE 4: Therapeutic.
BACKGROUND: Breast augmentation by cell-assisted lipotransfer (CAL) may achieve a more natural breast contour than silicone implants. Moreover, certain complications associated with these prosthetic devices can be avoided with CAL. Few prospective studies of CAL have been performed to examine long-term volume changes, effects on breast parenchymal tissue, and the effect of stromal vascular fraction (SVF) on graft survival. OBJECTIVES: In a 1-year prospective study of patients who underwent CAL, the authors examined changes in breast volume, effects on parenchymal tissue, and the impact of SVF on graft survival. METHODS: Following preoperative radiologic examination, patients underwent primary augmentation mammaplasty by CAL to both breasts. The SVF was characterized, and changes in breast volume were determined from magnetic resonance imaging studies performed postoperatively at 3 months and 1 year. A breast-imaging specialist reviewed all scans to detect changes in breasts. RESULTS: Five patients (10 breasts) were enrolled. Averagely 23% of grafted fat in volume was additionally harvested from each patient to isolate SVF cells. One year after CAL, breast volume had decreased to 47% of the initial postoperative volume. There was no parenchymal changes except small oil cysts. The ratio of SVF cell count to grafted fat volume showed no correlation with graft survival. Patterns of breast-volume decrease differed between older women with a history of breastfeeding and younger women without a history of breastfeeding. CONCLUSIONS: The addition of SVF cells did not appear to improve the retention of grafted fat in these patients. Skin tension may be an important factor influencing the absorption pattern of grafted fat. LEVEL OF EVIDENCE 4: Therapeutic.