How Fat Grafting Changed the Breast Reconstruction Paradigm: A Narrative Review

Purpose of Review: Since its origin, fat transfer has undergone several improvements, making it a key tool in many fields of plastic surgery, particularly breast reconstruction. It can be used in combination with other techniques to enhance outcomes, or in other cases, it may be the single procedure employed to address partial defects or complete autologous reconstructions. The present review aims to provide a comprehensive overview of the impact fat grafting has had on the field of reconstructive breast surgery. Recent Findings: Fat grafting provides the benefit of increasing volume while also boosting tissue quality. The volumetric use ranges from improving the aesthetics of a partial defect to the total reconstruction of an expanded breast, as well as complementing a heterologous and autologous reconstruction. It has changed the paradigm of reconstructive surgery improving outcomes and patients’ quality of life following radiotherapy, providing vitality to the tissues, improving the aesthetic results, and consequently, drastically reducing the associated complications. Summary: Autologous fat grafting has changed the paradigm of breast reconstruction, not only allowing the reconstruction of irradiated patients that were previously considered poor candidate for reconstruction, but also enhancing and optimizing aesthetic outcomes and patient satisfaction while also reducing the risks complications.