Jan-Willem Groen1, Vera L Negenborn1, Jos W R Twisk1, Johannes C F Ket1, Margriet G Mullender1, Jan Maerten Smit1. 1. Drs Groen and Negenborn are PhD Candidates, Dr Mullender is an Associate Professor and the Head of Research, and Dr Smit is a Plastic Surgeon, Department of Plastic Surgery, VU University Medical Center, and EMGO Institute for Health and Care Research, Amsterdam, The Netherlands. Dr Twisk is a Professor and Statistician, Department of Epidemiology and Biostatistics, VU University Medical Center, Amsterdam, The Netherlands. Mr Ket is a Medical Information Specialist, Medical Library, VU University Medical Center, Amsterdam, The Netherlands.
Abstract
BACKGROUND: Autologous fat grafting (AFG) is increasingly used in cosmetic surgery. However, its efficacy and safety are still ambiguous. Both a comprehensive overview and recapitulation of the relevant literature provide current evidence on the efficacy and outcomes of AFG in cosmetic breast surgery. OBJECTIVES: This review provides an up-to-date overview of the literature on AFG in cosmetic breast augmentation. METHODS: A systematic review of the literature on AFG used for cosmetic breast augmentation was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. This study included selected studies that were published between January 1996 and February 2016 and reported on 10 patients or more who had a minimal mean follow-up period of 1 year. RESULTS: In this study, 22 articles that reported on 3565 patients with follow-up periods ranging from 12 to 136 months were included. A complication rate of 17.2% (95% CI 15.9-18.5) was seen. Indurations were the most frequent complication (33.3%, 95% CI 20.4-46.3), followed by persistent pain (25%, 95% CI 0.5-49.5), and hematoma (16.4%, 95% CI 14.5-18.4). Mammograms revealed micro-calcifications (9.0%, 95% CI 6.4-11.5) and macro-calcifications (7.0%, 95% CI 3.8-10.2). The mean volume retention was 62.4% (range, 44.7-82.6%), with a satisfaction rate of 92% in patients and 89% in surgeons. CONCLUSIONS: AFG is a promising method in achieving autologous cosmetic breast augmentation with satisfactory volume retention and satisfaction rates in eight and six studies, respectively. Complications and radiological findings are comparable to those after implant augmentation. Future studies should focus on cancer occurrence and detection to further substantiate AFG safety. In addition, grafting methods and the use of auxiliary procedures to identify factors leading to better outcomes in terms of volume retention should be investigated. Finally, objective questionnaires are needed to represent patient satisfaction. LEVEL OF EVIDENCE: 3 Therapeutic.
BACKGROUND: Autologous fat grafting (AFG) is increasingly used in cosmetic surgery. However, its efficacy and safety are still ambiguous. Both a comprehensive overview and recapitulation of the relevant literature provide current evidence on the efficacy and outcomes of AFG in cosmetic breast surgery. OBJECTIVES: This review provides an up-to-date overview of the literature on AFG in cosmetic breast augmentation. METHODS: A systematic review of the literature on AFG used for cosmetic breast augmentation was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. This study included selected studies that were published between January 1996 and February 2016 and reported on 10 patients or more who had a minimal mean follow-up period of 1 year. RESULTS: In this study, 22 articles that reported on 3565 patients with follow-up periods ranging from 12 to 136 months were included. A complication rate of 17.2% (95% CI 15.9-18.5) was seen. Indurations were the most frequent complication (33.3%, 95% CI 20.4-46.3), followed by persistent pain (25%, 95% CI 0.5-49.5), and hematoma (16.4%, 95% CI 14.5-18.4). Mammograms revealed micro-calcifications (9.0%, 95% CI 6.4-11.5) and macro-calcifications (7.0%, 95% CI 3.8-10.2). The mean volume retention was 62.4% (range, 44.7-82.6%), with a satisfaction rate of 92% in patients and 89% in surgeons. CONCLUSIONS: AFG is a promising method in achieving autologous cosmetic breast augmentation with satisfactory volume retention and satisfaction rates in eight and six studies, respectively. Complications and radiological findings are comparable to those after implant augmentation. Future studies should focus on cancer occurrence and detection to further substantiate AFG safety. In addition, grafting methods and the use of auxiliary procedures to identify factors leading to better outcomes in terms of volume retention should be investigated. Finally, objective questionnaires are needed to represent patient satisfaction. LEVEL OF EVIDENCE: 3 Therapeutic.
Authors: Matthew J Davis; Aurelia T Perdanasari; Amjed Abu-Ghname; Santiago R Gonzalez; Edward Chamata; Charalambos K Rammos; Sebastian J Winocour Journal: Semin Plast Surg Date: 2020-02-15 Impact factor: 2.314
Authors: Maurizio B Nava; Phillip Blondeel; Giovanni Botti; Francesco Casabona; Giuseppe Catanuto; Mark W Clemens; Domenico De Fazio; Roy De Vita; James Grotting; Dennis C Hammond; Paul Harris; Paolo Montemurro; Alexandre Mendonça Munhoz; Maurice Nahabedian; Stefano Pompei; Alberto Rancati; Gino Rigotti; Marzia Salgarello; Gianfranco Scaperrotta; Andrea Spano; Costantin Stan; Nicola Rocco Journal: Plast Reconstr Surg Glob Open Date: 2019-10-28
Authors: Jan-Willem Groen; Andrzej A Piatkowski; John H Sawor; Janneke A Wilschut; Marco J P F Ritt; Rene R J W van der Hulst Journal: Surg Innov Date: 2018-09-24 Impact factor: 2.058