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Comparative Study of Patient-Reported Outcomes Following Autologous Fat Grafting Versus Implant-Based Augmentation in
Léa Dibiase1, François Ruiz2, Benjamin Haye2
1Plastic surgery department, Hautepierre Hospital, Strasbourg, France. lea.dibiase@orange.fr.
Background:
Tuberous breast (TB) deformity can be corrected with implant augmentation or autologous fat grafting (lipofilling), but comparative patient-reported outcomes are uncertain.
Objectives:
To compare postoperative health-related quality of life and satisfaction after lipofilling versus implants in TB correction, hypothesizing better outcomes and fewer complications with lipofilling.
Methods:
This is a single-center retrospective cohort of consecutive TB patients treated 2013-2024. Eligible patients underwent implant augmentation with glandular remodeling or exclusive lipofilling by six surgeons. Patient-reported outcomes were collected ≥6 months postoperatively using the postoperative BREAST-Q® Augmentation module (five domains). Complications, number of procedures, and hospital stay were recorded. Group differences used Welch and Chi-square tests (α = 0.05).
Results:
Of 53 eligible patients, 40 completed the survey (20 lipofilling; 20 implants). BREAST-Q® domain scores were similar for Satisfaction with Breasts (p = 0.21), Psychosocial Well-being (p = 0.11), and Sexual Well-being (p = 0.34). Lipofilling showed higher Physical Well-being (p < 0.01) and Satisfaction with Outcome (p = 0.01). The mean number of procedures did not differ (1.53 vs. 1.41; p = 0.28). Hospital stay was shorter after lipofilling (1.7 vs. 2.1 days; p < 0.01), and complications were less frequent (p = 0.014).
Conclusions:
In this retrospective cohort, lipofilling was associated with higher BREAST-Q® Satisfaction with Outcome and better Physical Well-being, a shorter hospital stay, and fewer complications than implants, without more reinterventions. Prospective adjusted studies with pre-/postoperative BREAST-Q® are warranted.
Level Of Evidence Iii:
This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .