Breast reconstruction with tissue expansion followed by serial autologous fat transfer: a report of six cases

To introduce a new method of breast reconstruction using tissue expander followed by serial autologous fat transfer (AFT). From May 1, 2013, to April 30, 2016, six breasts from six female patients (age range, 35-62 years) were reconstructed using tissue expansion followed by serial AFT. Clinical data were obtained, and each step of the operative methods was recorded. All six patients presented satisfactory symmetry in the contralateral breast. Three AFTs were performed in one patient, whereas four and five AFTs were performed in one patient and four patients, respectively. The intervals between the two adjacent AFTs were 3-5 months. A 450-ml round expander was used in this series, and the volume of each AFT was 50-150 ml. Two patients underwent mastopexy on the contralateral breasts to correct severe breast ptosis. Two patients underwent nipple-areola complex reconstruction 6 months after the last AFT. Tissue expansion followed by serial AFT is a safe and effective method for breast reconstruction. It can be an option for patients who do not prefer pedicled TRAM or DIEP flap transfer or pedicled latissimus dorsi myocutaneous flap coverage with implant placement and those who cannot afford the Brava plus fat graft