The volumetric analysis of fat graft survival in breast reconstruction.

BACKGROUND Fat grafting has emerged as a useful method for breast contouring in aesthetic and reconstructive patients. Advancements have been made in fat graft harvest and delivery, but the ability to judge the overall success of fat grafting remains limited. The authors applied three-dimensional imaging technology to assess volumetric fat graft survival following autologous fat transfer to the breast. METHODS Fat grafting surgery was performed using a modified Coleman technique in breast reconstruction. Patients undergoing the procedure were entered into the study prospectively and followed. Three-dimensional imaging was performed using the Canfield Vectra system and analyzed using Geomagic software. Breasts were isolated as closed objects, and total breast volume was calculated on every scan. RESULTS The data stratified patients into three groups with statistically significant parameters based on the volume of fat injected. The largest injected group (average volume, 151 cc) retained a volume of 86.9 percent (7 days postoperatively), 81.1 percent (16 days), 57.5 percent (49 days), and 52.3 percent (140 days). The smallest group (average, 51 cc) retained a volume of 87.9 percent (7 days postoperatively), 75.8 percent (16 days), 56.6 percent (49 days), and 27.1 percent (140 days). The intermediate group (average, 93 cc) retained 90.3 percent (7 days postoperatively), 74 percent (16 days), 45.7 percent (49 days), and 38.1 percent (140 days). Of note, irradiation or prior breast procedure type did not seem to affect the volume retention rate. CONCLUSIONS The authors' data suggest that fat retention is volume and time dependent. Patients receiving higher volumes of injected fat had slower volume loss and greater total volume retention.