Evaluation of immediate breast reconstruction after breast-conserving therapy using autologous free dermal fat flap

Abstract

We performed immediate breast reconstruction using autologous free dermal fat flap followed by irradiation to the breast in a total of 11 patients with breast cancer in whom breast-conserving therapy was difficult. Their postoperative courses were satisfactory and they had not experienced infection and necrosis of the flap Postoperative MRI examination confirmed that the blood flow had resumed only in the periphery of the flap, but no blood flow was seen in the center part of the flap and the size of the flap had become smaller than that when it had been collected. Core needle biopsy showed that fatty tissue of the flap had dropped while its tissue structure had been kept intact, of which histological features were compatible with those of coagulation and necrosis of the tissue due to decreased flap perfusion. The cosmetic evaluation of the reconstructed breast was rated as an average score of 10.0 according to the Sawai group's criteria of the Japanese Breast Cancer Society. The postoperative flap was felt hard in many cases, but good outcomes were gained in all cases in terms of the lowest hanging point of the breast, location of the nipple, and balance between the right and left breasts.
Autologous free dermal fat flap is an easier and less invasive breast reconstruction method than myocutaneous flap and implant methods. It requires no positioning changes of the patient and can be performed not only by plastic surgeons but also by general surgeons.