Quality of Life Management after Breast Surgery: The Standard Use of Fat Grafting
Surgical treatment is part of the gold standard for early breast cancer, but sequelae may be associated (30% of cases), with negative impact on social, physical, personal and sexual life. Supportive care and awareness of Quality Of Life (QOL) have modified the conventional care. The emergence and generalization of new techniques and technologies go in that direction. Methodology includes day surgery under general anesthesia, percutaneous without incision, iterative procedures following the volume targeted association of liposuccion-fat treatment and reinjection (fat grafting). The direct benefit is a volume gain; the indirect benefits are tissue rejuvenation with new vascularization, innervation and a better trophicity. The indications are for cosmetic sequelae and breast reconstruction (exclusive or combined). Beyond the former description, the Pros go for a low invasive surgery (low risk) with the benefit of liposuccion and an increase in mammogram transparency. On the other side, a lack of consistency in the results, the side effect of liposuccion (waves), the fear about stem cells and growth factors and benign modification in mammograms (calcifications, fat cysts). Results are mostly sustainable, and the main effect is the change in mentalities: cancer patients transform into aesthetic patients, without sickness. The impact is highly positive. It is concluded that the controlled and risk-free technique, the consistency of the results depends on the patient (comorbidities, past tarts, compliance, the experiment of the surgeon (learning curve, choice of the technic and devices used). Prediction of results using 3D is possible but not yet in reconstruction. The holistic allows strong relationship, confidence, trust and early adoption of the protocols proposed to the patient. Tailor-made treatment is a motto that should not be ignored, so as not to forget the main objective to treat a patient and not just a disease.