Optimizing aesthetic outcomes in immediate prepectoral breast reconstruction using sharp-needle intradermal fat grafting: a clinical experience

Mirco Pozzi , Luigi Losco , Pietro Susini , Gianluca Marcaccini , Vanessa Marron Mendes , Ishith Seth , Warren M. Rozen , Roberto Cuomo , Michela Schettino

Plastic and Aesthetic Research ›› 2025, Vol. 12 ›› Issue (1) : 23

PDF
Plastic and Aesthetic Research ›› 2025, Vol. 12 ›› Issue (1) :23 DOI: 10.20517/2347-9264.2024.146
Technical Note

Optimizing aesthetic outcomes in immediate prepectoral breast reconstruction using sharp-needle intradermal fat grafting: a clinical experience

Author information +
History +
PDF

Abstract

Breast reconstruction after mastectomy is a critical aspect of breast cancer treatment. This retrospective study analyzes the efficacy and safety of the sharp needle intradermal fat (SNIF) technique in immediate two-stage prepectoral breast reconstruction (PPBR) after mastectomy. A retrospective cohort analysis was conducted on patients who underwent SNIF fat grafting after mastectomy and PPBR. Demographics, surgical indications, procedures, and complications were analyzed. The SNIF procedure involves the precise injection of small fat particles into the dermal layer, aiming to improve skin texture and correct minor surface irregularities. Sixty-seven patients underwent the SNIF procedure after PPBR. The mean age was 53.2 years, with a range of 33 to 71 years. No serious complications, such as infection or fat embolism, were observed. Minor complications included ecchymosis in 30 patients and redness with mild swelling in 13 patients, all of which resolved within a few days after surgery. Patients and surgeons reported satisfactory cosmetic results. The SNIF technique, using small-diameter fat particles injected intradermally, shows promise for improving aesthetic results and minimizing complications in two-stage PPBR.

Keywords

Breast / breast reconstruction / SNIF / fat grafting

Cite this article

Download citation ▾
Mirco Pozzi, Luigi Losco, Pietro Susini, Gianluca Marcaccini, Vanessa Marron Mendes, Ishith Seth, Warren M. Rozen, Roberto Cuomo, Michela Schettino. Optimizing aesthetic outcomes in immediate prepectoral breast reconstruction using sharp-needle intradermal fat grafting: a clinical experience. Plastic and Aesthetic Research, 2025, 12(1): 23 DOI:10.20517/2347-9264.2024.146

登录浏览全文

4963

注册一个新账户 忘记密码

References

[1]

Breastcancer·Org. Breast cancer facts and statistics. Available from: https://www.breastcancer.org/facts-statistics. [Last accessed on 27 Jun 2025].

[2]

Ilonzo N,Tsantes S,Thu Ma AM.Breast reconstruction after mastectomy: a ten-year analysis of trends and immediate postoperative outcomes.Breast2017;32:7-12

[3]

Leff DR,Mayer E.Trends in immediate postmastectomy breast reconstruction in the United Kingdom.Plast Reconstr Surg Glob Open2015;3:e507 PMCID:PMC4596432

[4]

Gruber RP,Lash H,Apfelberg DB.Breast reconstruction following mastectomy: a comparison of submuscular and subcutaneous techniques.Plast Reconstr Surg1981;67:312-7

[5]

Susini P,Pierazzi DM.Advances on capsular contracture-prevention and management strategies: a narrative review of the literature.Plast Reconstr Surg Glob Open2023;11:e5034 PMCID:PMC10256414

[6]

Nahai F.Aesthetic aspects of breast reconstruction.Aesthetic Plast Surg1982;6:61-7

[7]

Becker H.The impact of animation deformity on quality of life in post-mastectomy reconstruction patients.Aesthet Surg J2017;37:531-6

[8]

Reitsamer R.Prepectoral implant placement and complete coverage with porcine acellular dermal matrix: a new technique for direct-to-implant breast reconstruction after nipple-sparing mastectomy.J Plast Reconstr Aesthet Surg2015;68:162-7

[9]

Sigalove S,Sigalove NM.Prepectoral implant-based breast reconstruction: rationale, indications, and preliminary results.Plast Reconstr Surg2017;139:287-94

[10]

Sbitany H,Lentz R.Prepectoral breast reconstruction: a safe alternative to submuscular prosthetic reconstruction following nipple-sparing mastectomy.Plast Reconstr Surg2017;140:432-43

[11]

Jones G,King V.Prepectoral immediate direct-to-implant breast reconstruction with anterior alloderm coverage.Plast Reconstr Surg2017;140:31S-8

[12]

Nahabedian MY.Two-stage prosthetic breast reconstruction: a comparison between prepectoral and partial subpectoral techniques.Plast Reconstr Surg2017;140:22S-30

[13]

Freeman BS.Subcutaneous mastectomy for benign breast lesions with immediate or delayed prosthetic replacement.Plast Reconstr Surg Transplant Bull1962;30:676-82

[14]

Redi U,Lo Torto F,Ribuffo D.Invited response on: dual-plane retro-pectoral versus pre-pectoral DTI breast reconstruction: an Italian multicenter experience.Aesthetic Plast Surg2021;45:1348-9

[15]

Schlenker JD,Ricketson G.Loss of silicone implants after subcutaneous mastectomy and reconstruction.Plast Reconstr Surg1978;62:853-61

[16]

Razzouk K,Al Khori N,Chouchane L.Breast reconstruction combining lipofilling and prepectoral prosthesis after radiotherapy.Plast Reconstr Surg Glob Open2020;8:e2659 PMCID:PMC7572071

[17]

Silva-Vergara C,Descarrega J,Yoon TS.Oncological outcomes of lipofilling breast reconstruction: 195 consecutive cases and literature review.J Plast Reconstr Aesthet Surg2016;69:475-81

[18]

Stillaert FBJL,Van Landuyt K.The prepectoral, hybrid breast reconstruction: the synergy of lipofilling and breast implants.Plast Reconstr Surg Glob Open2020;8:e2966 PMCID:PMC7413773

[19]

Turner A,Davis MJ,Hanson SE.Fat grafting in breast reconstruction.Semin Plast Surg2020;34:17-23 PMCID:PMC7023975

[20]

Cogliandro A,Tenna S,Persichetti P.The role of lipofilling after breast reconstruction: evaluation of outcomes and patient satisfaction with BREAST-Q.Aesthetic Plast Surg2017;41:1325-31

[21]

Zeltzer AA,Verpaele AM.Sharp-needle intradermal fat grafting (SNIF).Aesthet Surg J2012;32:554-61

[22]

Carraway JH.Commentary on: sharp-needle intradermal fat grafting (SNIF).Aesthet Surg J2012;32:562-3

[23]

Delay E,Toussoun G,Ho Quoc C.Lipomodelling: an important advance in breast surgery.Acta Chir Plast2013;55:34-43

[24]

Pozzi M,Giardino FR.Flowchart in post-bariatric surgery: a research for the appropriate type and timing of plasties reshaping the body.Aesthetic Plast Surg2024;48:1790-6

[25]

Susini P,Giardino FR.Selective capsulotomies and partial capsulectomy in implant-based breast reconstruction revision surgery.Breast J2024;2024:9097040 PMCID:PMC10914432

[26]

Bonomi R,Rapisarda IF,Sajid MS.Role of lipomodelling in improving aesthetic outcomes in patients undergoing immediate and delayed reconstructive breast surgery.Eur J Surg Oncol2013;39:1039-45

[27]

Giardino FR,Pozzi M.Erdheim-chester disease of the breast: first review and first case of isolated severe gynecomastia.Diagnostics2023;13:1239 PMCID:PMC10093613

[28]

Domenici L,Losco L.Muscle-sparing skin-reducing breast reconstruction with pre-pectoral implants in breast cancer patients: long-term assessment of patients’ satisfaction and quality of life.J Invest Surg2022;35:841-7

[29]

Delay E,Tousson G.Fat injection to the breast: technique, results, and indications based on 880 procedures over 10 years.Aesthet Surg J2009;29:360-76

[30]

Losco L.Aesthetic refinements in C-V flap: raising a perfect cylinder.Aesthet Surg J2018;38:NP26-8

[31]

Qari S,Farran E,Khamis S.Combined synergetic effect of lipoconcentrate fat grafting, nanofat transfer, platelet-rich plasma, microneedling, and CO2 fractional laser for plastic regenerative and esthetic surgery and cosmetic care.Cureus2023;15:e44035 PMCID:PMC10517633

[32]

Garza RM,Chung MT.Studies in fat grafting: Part III. Fat grafting irradiated tissue--improved skin quality and decreased fat graft retention.Plast Reconstr Surg2014;134:249-57 PMCID:PMC4116637

[33]

Cao Z,Wang ZH.High-density fat grafting assisted stromal vascular fraction gel in facial deformities.J Craniofac Surg2022;33:108-11 PMCID:PMC8694257

[34]

Pozzi M,Redi U.Managing the animation deformity in breast reconstruction transposing the implant to a partial prepectoral pocket: early experience and preliminary results with a new technique.J Plast Reconstr Aesthet Surg2023;86:139-45

[35]

Gentile P,Orzalesi L.Titanium-coated polypropylene mesh as innovative bioactive material in conservatives mastectomies and pre-pectoral breast reconstruction.Bioact Mater2021;6:4640-53 PMCID:PMC8144114

[36]

Gentile P.Systematic review: oncological safety of reconstruction with fat grafting in breast cancer outcomes.J Plast Reconstr Aesthet Surg2022;75:4160-8

[37]

Seth I,Gibson D.Autologous fat grafting in breast augmentation: a systematic review highlighting the need for clinical caution.Plast Reconstr Surg2024;153:527e-38

PDF

322

Accesses

0

Citation

Detail

Sections
Recommended

/