Effectiveness of Lipofilling in Postmastectomy Pain Syndrome: A Prospective Cohort Study

Background: Postmastectomy pain syndrome (PMPS) is a chronic condition affecting up to 50% of mastectomy patients, characterized by persistent pain that significantly impairs quality of life. Lipofilling, the transplantation of autologous fat, has emerged as a potential treatment option, offering pain relief and functional improvements through its regenerative properties. This study evaluates the effectiveness of lipofilling in managing PMPS and its impact on patients' quality of life. Methods: A prospective cohort study was conducted on 26 women diagnosed with PMPS at a tertiary care hospital in Jalisco, Mexico. This study exclusively included patients who had undergone modified radical mastectomy (MRM) without any form of breast reconstruction, in order to isolate non-implant-related causes of PMPS. Pain intensity and quality of life were assessed using the Visual Analog Scale (VAS) and EQ-5D-3L questionnaire at baseline, two weeks, and two months post-treatment. The lipofilling procedure included fat harvesting, processing via centrifugation, and reinjection into the affected chest wall areas. Changes in outcomes were analyzed using paired t-tests and Wilcoxon signed-rank tests, with significance set at p < 0.05. Results: The median VAS score decreased significantly from baseline (6, IQR 5-7) to two months post-treatment (4, IQR 3-5, p < 0.05). Quality of life scores improved markedly in the domains of mobility and usual activities (p < 0.05). No significant adverse effects were observed. Conclusion: Lipofilling is an effective intervention for reducing PMPS and improving quality of life, offering a promising option for reconstructive postmastectomy care.