A technique of whole and partial breast reconstruction is described based on tissue-engineering principles. Brava-assisted external tissue expansion generates an in situ biological recipient scaffold that favors the survival of large volumes of autologous fat graft required for breast reconstruction. Also presented are the results of the authors’ multicenter experience with this regenerative alternative in 488 patients over a 7-year period tracking surgical complications, patient satisfaction, efficacy, and costs.
Key points
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For large volumes of fat graft to survive, it is necessary to prepare a well-vascularized, large-volume recipient site.
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External tissue expansion with Brava can generate an in situ biological scaffold that will accept a large volume of fat graft required for breast reconstruction.
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With the Brava-assisted technique, it takes an average of 2.8 grafting procedures to regenerate a nonradiated breast mound, while radiated defects require an additional 2.1 procedures to reverse the radiation damage.
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Brava + autologous fat transfer is a minimally invasive, incisionless, safe, economic, attractive, and effective alternative method of breast reconstruction.
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