A prospective randomized study comparing centrifugation and sedimentation for fat grafting in breast reconstruction

Publication date: Available online 17 June 2017
Source:Journal of Plastic, Reconstructive & Aesthetic Surgery
Author(s): I. Sarfati, R.F.D. van la Parra, C.A. Terem-Rapoport, D. Benyahi, C. Nos, K.B. Clough
BackgroundFat grafting is an efficient method to correct large volumetric defects after mastectomy.There is ongoing debate regarding the best method of processing the harvested fat before fat grafting. The aim of this study was to introduce a new MRI-model and to compare two fat processing techniques measuring the gain in soft tissue thickness after fat grafting to the chest wall.MethodsFifty-one mastectomy patients (one double sided), who required delayed implant reconstruction, and with poor skin conditions were proposed fat grafting prior to implant reconstruction. At the time of fat grafting patients were randomly assigned to centrifugation or sedimentation of the aspirated fat. The trial was undertaken in a single-center private practice setting. The gain in soft tissue thickness of the chest wall was measured using an MRI model, with twelve predefined points for measurement. Two MRI's were performed, one prior to fat grafting and one eight weeks thereafter. The radiologist was blinded for the fat graft processing method used.ResultsSeven cases were excluded because they did not complete their second MRI. The analyses was thus based on 44 patients (one double sided). Centrifugation was performed in 21 cases and sedimentation in 24 cases. The mean gain in soft tissue thickness was +7.0 mm in the centrifugation group and +8.8 mm in the sedimentation group (p = .268). The mean operative time was 88 minutes in the centrifugation group and 78 minutes in the sedimentation group (p=. 11). There were no adverse events for any of the patients.ConclusionsWe developed a simple and reproducible MRI model to objectively measure and evaluate different fat processing techniques prior to fat grafting. With a median time of eight weeks after one session of fat grafting, there was no benefit of centrifugation over sedimentation.



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