Large Viable Fat Nodules, Months Post-Transfer, inside Radiated Breast Implant Pocket: A Case Report

Plastic and Reconstructive Surgery. Global Open
Sarah E HagartyJessica Luo

Abstract

The cell survival theory and the cell replacement theory contribute to the current thinking regarding free adipose graft persistence after transplantation and influence the principles applied to autologous fat transfer procedures. Both theories necessitate the reestablishment of circulation for graft survival. To minimize ischemic death, according to Khouri, fat grafts should be injected with at most 1.6-mm-wide ribbons to optimize the graft-to-recipient interface for oxygen diffusion and neovascularization. The graft is eventually incorporated into the surrounding tissue. We present a curious intraoperative finding, in a 51-year-old woman 2.5 months post-grafting for failed implant reconstruction after radiation. Several large, well-circumscribed, clearly viable adipose tissue nodules, up to 2 cm in diameter, were present inside the capsule. These were so loosely attached to the capsule of the breast pocket that a mere gentle hand sweep and irrigation after opening the cavity caused them to dislodge and float to the surface of the irrigation fluid. This finding begs additional questions about the current understanding of the mechanisms of tissue viability after grafting. It raises the clinical possibility that larger aliquots ...Continue Reading

References

Nov 27, 2014·Plastic and Reconstructive Surgery. Global Open·Roger K KhouriDennis P Orgill
Apr 2, 2015·Clinics in Plastic Surgery·Takanobu Mashiko, Kotaro Yoshimura
Apr 2, 2015·Clinics in Plastic Surgery·Nelson Sarto PiccoloMaria Thereza Sarto Piccolo
Jun 10, 2015·Philosophical Transactions of the Royal Society of London. Series B, Biological Sciences·Chi V Dang
Jan 26, 2016·Annals of Plastic Surgery·Lee L Q Pu
Jun 6, 2017·Plastic and Reconstructive Surgery·Roger K Khouri, Roger K Khouri

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