Hybrid Breast Reconstruction Revisited: Patient-Reported Outcomes Following Fat Grafting

Background/Objectives: Hybrid breast reconstruction (HBR), which combines implant-based reconstruction with autologous fat grafting (lipofilling), has emerged as a promising approach for improving both aesthetic and functional outcomes following mastectomy. This study aimed to evaluate patient-reported outcomes using the BREAST-Q questionnaire before and after lipofilling, focusing on aesthetic satisfaction, physical well-being, and quality of care. Methods: This before-after study included patients who underwent prepectoral implant-based reconstruction followed by one session of lipofilling between November 2024 and May 2025. The BREAST-Q questionnaire was administered preoperatively and at three months postoperatively. Statistical analyses were conducted to compare changes across aesthetic, functional, and care-related domains. Results: A total of 96 patients completed both pre- and postoperative questionnaires. Statistically significant improvements (p < 0.01) were observed in most aesthetic and psychosocial parameters, including satisfaction with breast appearance (Q1), psychosocial well-being (Q2), sexual well-being (Q4), and satisfaction with surgical outcomes (Q5). Physical symptoms such as discomfort (Q3) decreased significantly postoperatively. Satisfaction with medical care remained high, with minor improvements noted. No oncologic recurrences were reported. Conclusions: Hybrid breast reconstruction using fat grafting after implant placement offers significant benefits in terms of aesthetics, symptom relief, and patient satisfaction. It is a safe and effective procedure that can be widely integrated into clinical practice, provided that patient selection and technique are carefully considered.