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Fat Grafting Counteracts Radiation Effects

By Brian Kobienia, MD, FACS on February 18, 2013


 

Fat grafting may be another tool to be used to counteract the affects of radiation therapy used for treatment to prevent breast cancer recurrence after mastectomy and lumpectomy.

 

Traditionally, if a woman has had to undergo radiation therapy after a lumpectomy and then had the need to undergo a mastectomy due to a new cancer or some complication of scarring in the remaining breast her options were severely limited for breast reconstruction.  The technique of expanding the muscle and skin of the breast in preparation for a final soft implant relies on the characteristics of normal skin that allow stretch and relaxation.  It is these principles that allow a woman to carry a pregnancy to term.

 

Radiation therapy has an adverse affect on normal skin that increases fibrosis (scarring) and reduces the ability of the skin to stretch.  Is is because of this that traditionally we plastic surgeons don’t offer implant based reconstruction once radiation therapy has been given.  These women typically have to use a technique that involves using tissue from another part of the body such (flap), either abdominal (TRAM) or the back (latissimus dorsi).

 

A recent study of a small number of patients suggest that fat grafting the bed of the breast after mastectomy and radiation therapy seems to counteract the affects of radiation therapy and makes the skin “healthier”.   In this study, after several rounds of fat grafting - harvesting fat through liposuction of the abdomen or thighs these patients were able to then undergo implant based reconstruction without the traditional expected complications.  

 

The implication here is that patients may not have to undergo much more invasive surgical procedures to reconstruct their breast.  Additionally, the results suggests that fat, or ‘stem cells’ in fat may have a beneficial effects that might be captured and used elsewhere such as after head and neck surgery and radiation or after radiation for other cancers such as prostate or other abdominal cancers.

 

I think we are only scratching the surface in learning about the potential of fat!

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