Background: Fat grafting has been established as an
effective method in both breast augmentation and addressing
deformities. Many factors related to donor area, process of
transfer and recipient area influence the survival of grafted
fat.
This work was done to assess objectively the influence
of recipient area on fat graft survival using mammography
and magnetic resonance imaging volumetry.
Methods: Forty patients seeking breast enhancement
procedures for various indications were classified into two
groups:
• Group A included thirty patients seeking augmentation or
symmetrization with no history of previous breast disease
or surgery.
• Group B included ten patients presenting for breast enhancement
following previous disease or surgery resulting obvious
deformity.
Radiological volume assessment was carried out preoperatively
and three months following last surgical procedure.
Fat harvesting, processing and transfer methods were standardized
so they do not affect the results. Statistical analysis
was carried out to assess survival rates and other variables
and relations according to recipient bed characteristics.
Results: In group A (aesthetic) the mean retention rate
was 56.3%±7.7 (range 37-67%), while in group B (reconstructive)
the mean retention rate was 48.8%±9.8 (range 33-66%)
that required multiple grafting sessions in 40% of cases. Also
it has been found that the larger the preoperative recipient
area was, the more fat graft survival was obtained. Imaging
modalities could evaluate postoperative complications.
Conclusion: The recipient bed characteristics are a major
determinant of fat graft survival being significantly lower in
previously pathological bed and hence multiple sessions are
frequently required.