Li-Kuo Shen, Shoei-Loong Lin, Cheuk-Sing Choy, Wing P Chan, Mimmo Gasbarri and Ting-Kai Leung
Introduction: During the past few years in Taiwan, there has been a rapid growth of autologous fat grafting procedures performed for cosmetic reasons. We retrospectively demonstrate Complications of Autologous Fat Grafting in the breast, based on clinical presentations and breast MRI imaging. We also discuss the possible method of early detection of complications. Material and method: Twenty-one ethnic Chinese (Taiwanese) women were transferred for delicate breast MRI study in the past year. These patients had suffered different signs and symptoms following the procedure. Clinical and image information were collected from the hospital database. Results: Breast MRI successfully detected all viable fat tissues and complicated lesions of the breasts. The image findings corresponded to the clinical presentation and were used in therapeutic decision making. Fat necrosis with granuloma formations caused by graft rejection was the main complications. The most severe complication was an abscess formation and impending sepsis. Management procedures included operation or drainage; received oral antibiotics; and received clinical observation. Discussion and Conclusion: MRI is capable of detecting the surviving fat graft tissues, and to distinguish degree of malignancy from benign lesions. In complicated cases, the highest incidences showed granuloma formations and fat necrosis. However, laboratory data such as CRP, IgE and complement (C3 &C4) levels only reflected some of the infectious cases and could not be used as monitoring parameters. Breast MRI is an ideal tool for early detection of autologous fat complications without causing indistinguishable conclusions from malignancy. Breast MRI should be performed as early as possible for this complication, so that help for early treatment can be planned.