by Ruan, Qing Zhao;
Rinkinen, Jacob R.; Doval, Andres F.; Scott, Benjamin B.; Tobias, Adam M.; Lin,
Samuel J.; Lee, Bernard T.
Background: Autologous fat transfer is common in breast reconstruction because of
its versatility for use in contour deformities. The authors examined three
different fat grafting processing techniques for complications and safety
profile using their institutional database.
Methods: Retrospective review was performed of patients from a single
institution who had undergone autologous fat transfer following breast
reconstruction from 2012 to 2016. Individuals were separated into three cohorts
according to fat harvest technique: (1) centrifugation, (2) Telfa gauze, or (3)
Revolve. Complications between the groups were assessed. Results: A total of
267 cases of autologous fat transfer were identified (centrifugation, n = 168;
Telfa, n = 44; and Revolve, n = 55). Grafting by means of centrifugation was
associated with the greatest incidence of oil cysts (12.5 percent; p = 0.034),
postoperative adverse events observed in the clinic (13.7 percent; p = 0.002),
and total complications (25.6 percent; p = 0.001). The use of Telfa resulted in
the lowest rates of oil cyst formation (0 percent; p = 0.002) and total
complications (2.3 percent; p = 0.001). Grafting by means of centrifugation was
also associated with the highest frequency of repeated injections among the
three techniques after initial grafting (19.6 percent; p = 0.029). In contrast,
Revolve demonstrated a repeated injection rate of just 5.45 percent,
significantly lower when independently compared with centrifugation (p = 0.011).
Multivariate analysis demonstrated that higher total graft volume (p = 0.002)
and the use of centrifugation (p = 0.002) were significant risk factors for
adverse events seen in the clinic postoperatively.
Conclusions: Significant differences in postoperative
outcomes exist between varying fat transfer techniques. Autologous fat transfer
by means of centrifugation harbored the highest rates of complication, whereas
Telfa and Revolve exhibited similar safety profiles. CLINICAL QUESTION/LEVEL OF
EVIDENCE: Therapeutic, III.
