ABSTRACT

The ability to create a whole breast purely from a process of repeat fat grafting is a huge advance in breast reconstruction. Nonetheless, despite impressive outcomes from several prominent surgeons, others have struggled to achieve satisfactory results, and this topic of exclusive fat grafting remains controversial. Despite refinements of clinical technique, objective measurements of fat resorption approach 50% in large volume fat grafting for breast reconstruction. Focus has shifted to cellular manipulation of adipose tissue and its components in order to improve fat survival and feasibility of clinical translation. Stromal vascular fraction-enriched fat grafting has been used clinically with reported success in cosmetic augmentation3 and in reconstruction following breast-conserving oncological resections. Fat grafting used exclusively for whole breast reconstruction is a great advance in restoring tissues with minimally invasive approaches. Reduced donor site morbidity and ability to achieve a complete breast mound with only minimal incisions and autologous tissue moves the field of breast reconstruction forward in a dramatic way.