Clinical safety and breast symmetry after injectable acellular dermal fibers reconstruction: an MR-based volumetric...

Injectable acellular dermal fibers (ADFs) have recently emerged as a minimally invasive alternative for volume replacement following breast-conserving surgery (BCS). However, there is limited evidence regarding its long-term efficacy in preserving breast volume and symmetry. This study aimed to evaluate postoperative breast volume and symmetry through magnetic resonance (MR)-based three-dimensional (3D) volumetric analysis in patients who underwent BCS with injectable ADFs.

This retrospective study included 25 patients who underwent BCS with defect filling using a paste-type injectable ADFs. Clinical data and postoperative events were reviewed. Seven patients with both preoperative and 12-month postoperative breast magnetic resonance imaging (MRI) data were included in volumetric analysis to objectively assess changes in breast volume and symmetry.

Postoperative complications were rare, with only one case (4.0%) of seroma requiring a single aspiration. Postoperative breast volume differences (Δ) ranged from 22.1 to 320.2 cm³. MR-based volumetry demonstrated that although total breast volume gradually decreased during the year after surgery-likely influenced by adjuvant radiotherapy or weight loss-bilateral breast symmetry was consistently preserved or even enhanced relative to preoperative measurements. Injectable ADFs provided stable, long-term contour support without causing clinically significant distortion.

Injectable ADFs may effectively maintain long-term breast symmetry after BCS, even when the postoperative volume is reduced. These findings suggest that injectable ADFs is an available option for volume replacement, particularly for maintaining cosmetic outcomes following BCS.