Evaluation of Volumetric, Clinical, and Aesthetic Results of Breast Lipostructuring After Breast-Conserving Surgery and Radiotherapy: An Observational Study

Abstract

Objective: This study aimed to assess volumetric outcomes indicated by fat graft retention, clinical aspects, and aesthetic results of immediate lipofilling in breast cancer patients undergoing breast-conserving surgery followed by radiotherapy. Material and Methods: Forty women with early-stage breast cancer underwent breast-conserving surgery with immediate lipofilling at the National Cancer Institute, Cairo, Egypt. All patients received adjuvant radiotherapy. Fat retention was evaluated by magnetic resonance imaging (MRI) at 1st, 9th, and 18th months and by mammography at 1st and 18th months post procedures. Clinical outcomes were recorded, and patient and surgeon satisfaction were assessed on a scale of 1 to 10. Results: The patients’ mean age was 49.3 years, and their mean body mass index was 24.4 kg/m². Most patients (72.5%) had invasive ductal carcinoma. The mean injected fat volume was 183 ml, primarily harvested from the abdomen. Patient and surgeon satisfaction rates were high, with 92.5% rating outcomes as excellent to good. Clinically, edema was present in all cases; infection was present in only 5%, and hematoma in 17.5%. Fat retention rates assessed by mammography and MRI showed a gradual decline overtime: from 77% at the 1st month to 56% in the 18th month, versus 90% to 61% over the same period, respectively. The overall complication rate was acceptable, and most adverse events were manageable and non-severe. Conclusion: Immediate lipofilling after breast-conserving surgery and radiotherapy is feasible, with a high level of satisfaction for both patients and surgeons, manageable complication rates, and substantial fat retention over 18 months.