Radiographic findings after breast augmentation by autologous fat transfer

Fat transfer to healthy breasts, that is, in women with no history of breast disease, particularly breast cancer, is becoming increasingly popular. The main issue remains whether the transfer of fat cells to the native breast hampers breast imaging. This pilot study aimed to assess the effectiveness of radiographic evaluation after breast lipomodeling and to propose objective elements for the detection of mammographic signs, and for postoperative evaluation of breast density and Breast Imaging Reporting and Data System (American College of Radiology) classification.

The authors retrospectively reviewed the radiographic findings of patients undergoing breast lipomodeling between 2000 and 2008. A descriptive semiologic analysis was conducted. Then, the authors compared breast tissue density and Breast Imaging Reporting and Data System categorization in 20 patients with preoperative and postoperative images available for review.

The descriptive analysis identified 16 percent of mammograms with microcalcifications, 9 percent with macrocalcifications, 25 percent with clear well-focused images of cystic lesions, and 12 percent with tissue remodeling. The comparative study showed no statistically significant difference between breast density findings before and after fat injection, whether using the American College of Radiology classification or a personalized rating system. Similarly, no significant difference was observed using the American College of Radiology Breast Imaging Reporting and Data System categorization before and after fat grafting.

Radiographic follow-up of breasts treated with fat grafting is not problematic and should not be a hindrance to the procedure. However, the authors' preliminary results should be confirmed in larger series, and the radiographic follow-up of women undergoing breast lipomodeling should be standardized to ensure reproducibility and improve patient safety.