Objectives: We present our long-term follow-up of radiated breast cancer patients who underwent LipoBed protocol. This consist of prior 2-3 fat grafting session with regenerative and reshaping purposes when needed, in order to downgrade the radiation damage, before to proceed with definitive implant placement.
Introduction: Breast reconstruction in radiated patients represents a challenge to the plastic surgeon when autologous tissue reconstruction is not feasible or refused by the patient, as implant placement is often fraught with significant complications and morbidity. In 2012 we publish an alternative reconstructive approach for this subset of patient, that we called Lipobed with a very promising preliminary evidence.
Materials / method: The authors retrospectively reviewed 60 cases of irradiated breasts treated with fat grafting and subsequent alloplastic reconstruction/breast augmentation with at least 5 years follow-up. The evaluation methods were clinical and photography-based assessments. Comparative histological assessment of implant capsule in radiated cases treated with Lipobed and not-radiated ones was also performed. The BREAST-Q was used to quantify patient satisfaction.
Results: The reconstructive outcomes were excellent to good in 93.7% of patients. Patient satisfaction was marked high, to very high. Comparative histology analysis included capsular thickness, collagen fiber alignement, α-SMA, ER-α and ER-β. We registered a Baker grade 1 capsule contracture in all patients.
Conclusion: The authors’ experience shows that Lipobed represents a valid reconstructive option in selected patients with irradiated breasts with good-long term follow-up. Fat grafting seems to reduce the radiation-induced complications in implants.
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