Safety of Lipofilling as a Secondary Procedure in Breast Reconstruction

Introduction: Lipofilling is a useful surgical technique for breast reconstruction. However, there remains a concern regarding the long-term safety of fat grafting with its stem cell population in breast cancer patients. This study evaluated the safety of lipofilling procedure in breast reconstruction. Materials and Methods: We conducted this observational study that included patients who underwent lipofilling with or without adipose-derived regenerative cells (ADRC) for breast reconstruction. We divided patients into 2 groups. Group I comprised of patients with lipofilling for lumpectomy defects. Group II included patients with post mastectomy reconstruction defects. These two groups were analysed using Chi-square test, PValue of <0.05 was considered significant. Results: A total of 53 patients had lipofilling for defects following breast cancer surgery. 25 patients had lumpectomy defects while 28 had post-mastectomy reconstruction defects. 29 out of 53 patients had lipofilling with ADRC. An average of 232 ml of fat (80-420 ml) was injected. The average follow-up was 50 months. Thirty-three percent (18/53) developed a palpable lump. Imaging confirmed benign changes including fat necrosis in 13, oil cyst in 3 and scarring in 2 patients. No loco-regional recurrence was identified in either group. Four patients developed metastasis at an average of 28 months following lipofilling and 56.6 months from primary breast cancer surgery. Out of four patients three had stage III disease and died of visceral metastasis. Conclusion: Lipofilling is a safe technique for breast reconstruction. We found no increased risk of local recurrence or new cancer development. Patients with stage III disease were found to be at a higher risk of distant metastases.