Defect Reconstruction After Breast Conservation Surgery and Radiation with Lipofilling

Fig. 52.1

(a) Preoperative view. Neoadjuvant chemotherapy resulted in a partial clinical remission of the tumors of both breasts. Bilateral oncoplastic reduction mammoplasty was planned. Although the cancer showed a partial remission in both breasts, wide resection was necessary due to extensive intraductal carcinoma in situ. (b) Following bilateral surgery and radiation, a pronounced tissue defect was seen in both the upper quadrants. (c) Postoperative view following lipofilling

52.2 Surgery

The areas to be grafted with fat were outlined on the breast. Additional lipofilling was done in the subclavicular regions after removal of the port catheters. 400 cc of fat was aspirated from the abdomen using the Body Jet ^R Lipoaspiration system (no centrifugation of the aspirated fat necessary). The fat was transferred into syringes, and 200 cc of fat was injected subcutaneously in both breasts through multiple passages. No dressings or a brassiere was applied after lipofilling; no antibiotics were given. Three months after surgery another lipofilling was done injecting 100 cc in each breast.