Fat grafting for breast shaping after implant removal

Objective. To estimate fat grafting as an option for breast shaping after implant removal. Material and methods. Thirty patients aged 29—69 years (mean 38.5 (35.8—44.3) years) were enrolled in the study between 2013 and 2022. In 13 (43.3%) cases, lipofilling was performed in delayed period, in 17 (56.7%) case — immediately after implant removal. Skin cover reduction was not required in 12 patients (40.0%) (9 with delayed lipofilling and 3 with immediate lipofilling). Lipofilling combined with mastopexy was performed in 18 patients (60.0%) (4 with delayed lipofilling and 14 with immediate lipofilling). Postoperative results were assessed using photography and 10-point scale of patient satisfaction. The follow-up period after surgery ranged from 1 to 9 years. Results. In all cases, we achieved correct attractive breast shape and high patient satisfaction (7—10 points). There was no correlation between volumes of implant and injected fat graft (correlation coefficient –0.121, p=0.374). Postoperative nodules within ≥ 1 year were detected in 10 cases (oil cysts and lipogranulomas in 6 (20%) and 4 (13.3%) patients, respectively). They did not require additional diagnostic actions. In 1 (3.3%) case, accumulation of fat graft in an incompletely fused implant cavity required a single puncture. Conclusion. Lipofilling is effective and safe for breast shape correction after implant removal. Further studies are needed to confirm our findings.