PRP enhanced breast fat transfer after radiation

Question

Hi, I have had two breast fat transfers in the past 7 months, following a partial mastectomy and radiotherapy. Only a small amount of fat survived both times. I am wondering if a PRP or PRF enhanced fat transfer might be an option for my last procedure? Is this a safe procedure for a radiated breast? My surgeon believes it is the prior radiation affecting my results and I am keen to have one final go at fat grafting to see if I can achieve something close to the ever-elusive symmetry. Thank you!

Ronald J. Edelson, MD · Answer

Your surgeon is correct that radiation reduces the ability of fat transfer to take. The addition of PRP May or may not make a difference. Nobody really knows. It’s a matter of whether you want to give it a try. I guess there’s nothing to lose

Brian Bassiri-Tehrani, MD · Answer

Radiation therapy makes healing wounds and surgery difficult, including fat transfer. Adding PRP/PRF may help with fat graft survival, although it will be difficult to predict to what extent it will be beneficial. It will not be harmful to add PRP/PRF, so there is no downside to trying it, and it is safe overall.
The most important thing to keep in mind is that depending on the dose and extent of radiation therapy received, the survival of fat will be uncertain.

Martin Jugenburg, MD · Answer

Hello, thank you for your question. Congratulations to your recovery. Even without radiation, fat survival in the breasts is minimal and only increase by half a cup size. Speak to your plastic surgeon about different options. There are some new techniques that can be used.

Daniel Barrett, MD · Answer

Dear electra03,
fat transfer breast augmentation is a viable alternative for women who desire larger breasts without the use of implants. Fat transfer is also widely used in reconstruction of the breast after a mastectomy or lumpectomy. It can also be very effective in correcting the size and shape of the breasts due to genetic problems such as tuberous breast or Poland Syndrome, two conditions that look like misshapen or underdeveloped breasts.In addition, the following scenarios are also reason to consider breast fat grafting:• If you have chest areas that appear creased and sunken• If you desire more permanent correction than is provided by temporary fillers• If you wish to improve your body contour, revise scars, fill bodily depressions and rejuvenate the natural curve of your breasts• To fill in contour irregularities or hide obvious signs of breast implantsYou should discuss your concerns with a board certified plastic surgeon and make sure your surgeon understands your concerns and your breast augmentation goals. Only after a thorough examination you will get more information and recommendations.
Daniel Barrett, MDCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery

Randal Haworth, MD, FACS · Answer

Fat grafting, also known as fat transfer, can be a viable option for breast reconstruction or aesthetic purposes. However, the success of fat grafting can be influenced by factors such as prior radiation therapy and the quality of the recipient tissue.

Radiation therapy can have various effects on the tissues, including reducing the vascularity and compromising the survival of transferred fat cells. This can make it more challenging for the transplanted fat to integrate and thrive in the radiated area. The compromised blood supply can limit the survival of the fat cells, leading to a lower volume retention rate.

In an attempt to improve the success of fat grafting in radiated breasts, some surgeons may utilize Platelet-Rich Plasma (PRP) or Platelet-Rich Fibrin (PRF) as adjunct therapies. PRP and PRF contain growth factors that can potentially enhance tissue healing and improve the survival of transplanted fat cells. However, the effectiveness of these techniques in radiated tissue is still being evaluated, and results may vary.

It is crucial to consult with a qualified plastic surgeon who has experience in breast reconstruction and fat grafting, particularly in radiated breasts. They will be able to assess your specific situation, consider the potential benefits and risks, and provide you with personalized recommendations for achieving your desired symmetry. They can discuss the feasibility of PRP or PRF enhanced fat transfer in your case and provide you with the most up-to-date information on the procedure's safety and potential outcomes.

I hope this helps,
Best of luck !

Hilton Becker, MD · Answer

Radiation does affect fat graft survival
We use several techniques to facilitate fat grafting  these include 
Pre operative expansion 
Increasing the numbes of stem cells,adding PRP or PRF 
micronizing the fat prior to injection

Connie Hiers, MD, FACS · Answer

PRP might increase the survival of the fat transfer, but it will need to be collected in a completely closed and sterile system when injected.

Mats Hagstrom, MD (license on probation) · Answer

Irradiated tissues will not do well with fat transfer.
Without including pictures, we can’t make an assessment, but the standard textbook answer for irradiated tissues is generally going to be autologous tissue reconstruction with some type of rotation or free flap.
Irradiated tissues are notoriously difficult to work with, and have poor healing characteristics and will not properly support grafted tissue.
Adding plasma, is it going to change the primary problem which is radiation damage to your tissue.
Consult with plastic surgeons who have sufficient experience with all types of breast reconstructive surgery, including free, flap surgery.
Best,
Mats Hagstrom, MD

PRP enhanced breast fat transfer after radiation

Answers (8)

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