HOW – A study was conducted at the Sant’Anna hospital which highlighted the benefits of autologous fat grafting (lipofilling) in reducing complications related to breast reconstruction with prosthesis, in particular after post-mastectomy radiotherapy treatments. The research, carried out by the Asst Lariana Plastic Surgery team and published, with impact factor 3.3, in the international scientific journal Journal of Clinical Medicine, thanks to the decisive contribution of Dr. Alessia De Col and Dr. Francesco Buttarelli, examined 32 women who, between 2010 and 2021, underwent a two-stage prosthetic breast reconstruction after oncological surgery and radiotherapy. Co-authors of the research are Dr. Anna Scevola, Dr. Ferruccio Paganini and Dr. Melissa Akuma.
All patients received at least one lipofilling session, a technique that involves the removal and reinsertion of autologous fat to improve tissue quality. The results are promising: at an average follow-up of 7.7 years, the incidence of capsular contracture (one of the main post-implant complications) was 18.8%, no patient presented severe forms and no oncological relapses were recorded. All patients kept the prosthesis without the need to switch to an autologous reconstruction, with a high degree of satisfaction in terms of softness and aesthetic result.
“Lipofilling is confirmed as a safe and effective strategy for maintaining prosthetic breast reconstruction after radiotherapy. In this long-term series – explains Anna Scevola, head of Plastic Surgery at the Sant’Anna hospital – fat grafting was associated with a lower incidence of capsular contracture compared to historical data, the absence of serious contractures and no oncological events. For selected patients who are not suitable for autologous reconstruction, lipofilling can represent a valid alternative to preserve the viability of the implant, improve tissue quality and reduce the need for salvage operations.”
Asst Lariana’s Plastic Surgery, directed by Scevola, has also been the protagonist of two important scientific events in recent weeks: the Italian Congress of Microsurgery and the National Congress of Plastic and Reconstructive Surgery (Sicpre). The specialist spoke by presenting the experience gained in Como in the reconstruction of loss of bone substance in the limbs through the use of the vascularized fibula. “It is a complex but extremely effective technique in cases where there are serious bone defects, in particular following trauma or oncological operations – he underlines -. The use of a microvascular bone flap allows the functionality of the limb to be restored and significantly improve the patient’s quality of life”.
Also speaking at the Congress was Dr. Melissa Akuma, a specialist at the University of Naples Federico II undergoing training at Sant’Anna. His contribution concerned chronic neuropathic breast pain after mastectomy and axillary surgery. “Chronic post-surgical pain after breast surgery is a problem that is still underestimated. Understanding its characteristics and causes – concludes Dr. Scevola – is essential to develop more effective prevention and treatment strategies”. A double recognition for the clinical and research work of the Como facility, which is increasingly active also on a national scientific level.
(Per approfondimenti si rimanda al Journal of Clinical Medicine, “Long-Term Outcome in Implant Breast Reconstruction and Radiotherapy: The Role of Fat Grafting” di Alessia De Col, Francesco Buttarelli, Melissa Akuma, Ferruccio Paganini and Anna Scevola, al seguente link: Long-Term Outcome in Implant Breast Reconstruction and Radiotherapy: The Role of Fat Grafting | MDPI)
