Valmadrid, Al C.; Kaoutzanis, Christodoulos; Wormer, Blair
A.; Farinas, Angel F.; Wang, Li; Al Kassis, Salam; Perdikis, Galen; Braun,
Stephane A.; Higdon, Kent K
Plastic and
Reconstructive Surgery: September
2020 - Volume 146 - Issue 3 - p 486-497
Background:
The purpose of this study was to compare the commonly used
fat grafting techniques—Telfa rolling and a closed washing system—in breast
reconstruction patients.
Methods:
Consecutive patients undergoing fat grafting were
retrospectively reviewed and grouped by technique. Patients with less than 180
days of follow-up were excluded. Demographics, operative details, and
complications were compared using univariate analysis with significance set at
p < 0.05.
Results:
Between January of 2013 and September of 2017, 186 women
underwent a total of 319 fat grafting procedures. There was no difference in
demographics, number of procedures performed, volume of fat grafted, and number
of days after reconstruction that fat grafting was performed between groups (p >
0.05). Telfa rolling patients had longer operative times for second fat
grafting procedures (implant exchange often completed prior) [100.0 minutes
(range, 60.0 to 150.0 minutes) versus 79.0 minutes (range, 64.0 to 94.0
minutes); p = 0.03]. Telfa rolling breasts had more palpable masses requiring
imaging (26.0 percent versus 14.4 percent; p = 0.01) and an increased incidence
of fat necrosis (20.6 percent versus 8.0 percent; p < 0.01). The closed
washing system was found to be an independent predictor of decreased rates of
imaging-confirmed fat necrosis (OR, 0.29; p = 0.048). There was no difference
in fat necrosis excision or cancer recurrence between the groups.
Conclusion:
The closed washing system was independently associated with
decreased rates of imaging-confirmed fat necrosis compared to Telfa rolling
without an increase in other complications. CLINICAL QUESTION/LEVEL OF
EVIDENCE: Therapeutic, III.
