Reconsidering cell-assisted lipotransfer for breast augmentation: effect of stromal vascular fraction enrichment on graft survival assessed with 3-dimensional laser scanning

Background: Cell-assisted lipotransfer (CAL) has been proposed to be beneficial for improving graft retention. Clinically, CAL involves the isolation of the stromal vascular fraction (SVF) from a portion of the lipoaspirate at the time of surgery. However, most studies related to SVF breast augmentation lacked a rigorous methodology and well-designed control. Objective: We aimed to determine the potential improvement of SVF enrichment in fat grafting for breast augmentation with objective volume assessment. Methods: From April 2015 to January 2016, 169 patients were enrolled after applying the exclusion criteria. Among them, 97 patients who underwent conventional fat grafting for breast augmentation were assigned to group A. The other 72 patients underwent SVFenriched fat grafting for breast augmentation and were assigned to group B. A retrospective comparative study was conducted to evaluate the graft survival using 3-dimensional laser scanning. Results: There was no significant difference between the 2 groups in terms of mean age, original breast volume, grafted fat volume, and postoperative weight change. Breast volume assessments revealed that the percentage of graft survival at 12 months was 69.2% in group A and 71.1% in group B, with no significant difference (p=0.641). The preoperative body mass index was significantly lower in group A than in group B. The volume of suctioned fat was significantly less in group A. The operation time was significantly shorter in group A. The postoperative complication rates were significantly lower in group A than in group B. Conclusion: SVF-enriched fat grafting for breast augmentation was associated with a larger amount of harvested fat, a longer operation time, and a higher incidence of complications. The graft retention rate was not significantly increased. The findings of our study do not support the use of SVF in fat grafting for breast augmentation. Level of Evidence: IV