Symptomatic Outcomes After Autologous Fat Grafting in Irradiated Postmastectomy Chest Wall

TL;DR

Autologous fat grafting improved symptoms like redness and burning in irradiated chest wall tissue after mastectomy, with no complications observed.

Contribution

This pilot study provides early evidence that fat grafting can alleviate symptoms in irradiated postmastectomy tissue, beyond what imaging can capture.

Findings

Symptoms like erythema, burning sensation, and pruritus improved significantly at six months.

No postoperative complications were observed in five patients who underwent fat grafting.

Scar pliability scores increased, indicating improved tissue flexibility.

Abstract

What are the main findings?
Autologous fat grafting reduced patient-reported symptoms in irradiated postmastectomy chest wall tissue at 6 months.The largest descriptive improvements were observed for erythema, burning sensation and pruritus, without postoperative complications.

Autologous fat grafting reduced patient-reported symptoms in irradiated postmastectomy chest wall tissue at 6 months.

The largest descriptive improvements were observed for erythema, burning sensation and pruritus, without postoperative complications.

What are the implications of the main findings?
Symptom based evaluation captures clinically relevant benefits of fat grafting that are not reflected by imaging alone.Autologous fat grafting can be considered a safe adjunctive option for symptomatic relief in selected irradiated postmastectomy patients.

Symptom based evaluation captures clinically relevant benefits of fat grafting that are not reflected by imaging alone.

Autologous fat grafting can be considered a safe adjunctive option for symptomatic relief in selected irradiated postmastectomy patients.

Background/Objectives: Radiotherapy of the chest wall after mastectomy frequently leads to fibrosis, reduced tissue elasticity, erythema, pain and chronic skin-related symptoms that complicate reconstructive strategies. Autologous fat grafting has been proposed as a regenerative option for radiation induced soft tissue damage, but clinical data focused on patient-reported symptoms remain limited. The objective of this study was to describe symptomatic and clinical changes after autologous fat grafting in irradiated postmastectomy chest wall tissue. Methods: This pilot observational study included five female patients with a history of mastectomy followed by adjuvant chest wall radiotherapy. All patients underwent a single session of standard autologous fat grafting without adipose derived stem cell enrichment. Patient-reported symptoms, including pruritus, local discomfort, burning sensation and erythema, were recorded preoperatively and at six months using a standardized 0 to 5 scale. Scar pliability was assessed by two experienced physicians using the same scale. Only descriptive statistical analysis was performed. Results: All patients demonstrated lower postoperative symptom scores at six months. Mean reductions were observed for erythema (71.4 percent), burning sensation (61.1 percent) and pruritus (57.1 percent). Local discomfort decreased by 33.3 percent. Mean scar pliability scores increased from 2.2 to 3.2. No postoperative complications, such as infection, fat necrosis or oil cyst formation, were recorded. All patients completed the six month follow up. Conclusions: In this small pilot observational study, autologous fat grafting was well tolerated and associated with descriptive improvement of patient-reported symptoms and scar pliability in irradiated postmastectomy chest wall tissue. These findings suggest a potential symptomatic benefit of fat grafting, while larger studies with objective imaging and histological correlation are required to confirm efficacy and durability.

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