734 Autologous Fat Grafting for Contour Deformities After Breast-Conserving Surgery: Systematic Review of Oncological Safety and Aesthetic Outcomes

Abstract Aim To systematically review the evidence on the oncological safety, aesthetic outcomes, and complication rates of autologous fat grafting (AFG) for correcting contour deformities after breast-conserving surgery (BCS). This review synthesizes current literature to establish a comprehensive overview of the procedure's risks and benefits. Method A systematic literature search of PubMed and MEDLINE was conducted for studies evaluating AFG after BCS. Primary outcomes included rates of local cancer recurrence, patient-reported satisfaction, and fat graft retention. Secondary outcomes were complication rates and changes in quality of life, assessed using validated tools like the Breast-Q. Out of an 545 initial papers, 48 papers were included in this study . Results The analysis confirmed high patient satisfaction rates (90-95%) and significant improvements in breast symmetry and contour. Oncological safety was well-supported, with multiple studies showing no significant increase in local recurrence rates compared to BCS alone (annual rate 0.86% with AFG vs. 0.7% without). The average one-year fat retention rate was approximately 50%. Overall complication rates were low (5-10%), with fat necrosis and oil cysts being the most common but typically minor. Patient-reported outcomes showed significant gains in psychosocial and physical well-being. Conclusions Autologous fat grafting is a safe and effective procedure for correcting contour deformities after BCS, providing high patient satisfaction and improved quality of life without compromising oncological safety. The primary limitations are unpredictable graft retention and the potential for benign radiologic changes. Further research should focus on standardizing techniques to optimize fat survival and defining long-term outcomes.