Comparison of Breast Reconstruction Strategies Using Exclusive Lipofilling or Prosthesis After Total Mastectomy for...

Total mastectomy for breast cancer is an impactful procedure, and breast reconstruction plays a crucial role for women diagnosed with the disease.

The objective of the authors of this study is to compare satisfaction, morbidity, and timelines of 2 breast reconstruction techniques after breast cancer: breast prosthesis and exclusive lipofilling.

This is a comparative, retrospective, unicentric study on patients who underwent total mastectomy between May 2014 and May 2020. Satisfaction is assessed using the BREAST-Q questionnaire at least 2 years after the start of the reconstruction (4.8 [±0.16] years in the implant group and 5.4 [±0.12] years in the lipofilling group, P = .044). Morbidity is evaluated using the Clavien-Dindo classification.

One hundred and one patients were included in the study (60 in the prosthesis group and 41 in the lipofilling group). The response rate to the questionnaire was 63.3% (38 patients) in the prosthesis group and 70.7% (29 patients) in the lipofilling group. The lipofilling technique appears to provide better satisfaction for the "sexual well-being" item of the BREAST-Q in multivariate analysis (65.75 ± 1.92 vs 54.87 ± 1.46, multivariate P = .03). The major complication (Grade III, IV or V) rate was 20% in the prosthesis reconstruction group compared with 0% in the lipofilling group (multivariate P= .05). Lipofilling often requires longer reconstruction times, but reoperations are more frequent in prosthesis reconstruction, extending the reconstruction periods.

These data should be confirmed by other studies to better guide the choice of reconstruction type.

For image description, please refer to the figure legend and surrounding text.