Complications after autologous fat injection to the breast

Although autologous fat injection (fat grafting) to the breast was performed widely throughout the twentieth century, the authors at their hospital have recently had to repair the damage suffered by a number of patients subjected to this procedure. The authors are concerned that this procedure is being performed incorrectly by untrained and untutored individuals, especially in Japan. The authors report several cases of complications after this procedure. Several related issues are discussed.

The authors retrospectively reviewed 12 patients who had received autologous fat grafts to the breast and required breast surgery and/or reconstruction to repair the damage presenting between 2001 and 2007. The symptoms are described and the fat grafting procedures that were used are analyzed.

All 12 patients (mean age, 39.3 years) had received fat injections to the breast for augmentation mammaplasty for cosmetic purposes. They presented with palpable indurations, three with pain, one with infection, one with abnormal breast discharge, and one with lymphadenopathy. Four cases had abnormalities on breast cancer screening. All patients underwent mammography, computed tomography, and magnetic resonance imaging to evaluate the injected fats.

Autologous fat grafting to the breast is not a simple procedure and should be performed by well-trained and skilled surgeons. Patients should be informed that it is associated with a risk of calcification, multiple cyst formation, and indurations, and that breast cancer screens will always detect abnormalities. Patients should also be followed up over the long-term and imaging analyses (e.g., mammography, echography, computed tomography, and magnetic resonance imaging) should be performed.