Objectives: The present project aimed to determine potential factors affecting the take rate in autologous fat grafting to the breast in order to contribute to an optimization of this valuable method in the future.
Introduction: Autologous fat grafting is considered an excellent minimal invasive for reconstructing breast volume and has recently also gained attention in the field of aesthetic breast augmentation. However, the grafted lipoaspirates are partially degraded by the body's own resorption processes, leading to a final take rate of only about 40%. Several sessions are therefore usually required to achieve satisfactory results. To date, no gold standard could be defined from numerous aspiration, processing, as well as infiltration techniques of autologous adipose tissue.
Materials / method: 10 patients undergoing elective breast reconstruction with autologous fat grafting were included. Punch biopsies and lipoaspirates were harvested from the donor area and perioperative lipometer measurements were performed measure subcutaneous tissue thickness. Electron microscopy, histological, laboratory chemical analyses and FACS analyses of lipoaspirates were performed. In addition, various other patient-related characteristics were correlated with the take rate. Further 45 lipoaspirates obtained via various techniques were analyzed regarding their quality and vitality.
Results: Various patient- and surgery-related risk factors were found to impair the take rate in autologous fat grafting. Qualitative differences of lipoaspirates can especially be shown in images obtained via electron microscopy. Additional analysis of 45 lipoaspirates yields interesting results regarding the influence of different liposuction and processing techniques, the use of tumescent fluid on the quality and vitality of adipocytes as well as the importance of patient-related characteristics.
Conclusion: Knowledge of possible patient- and surgery-related factors impairing the take rate is of utmost importance to achieve optimal results and contribute to a reduced complication rate and number of required grafting sessions.
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