Twelve Month Outcomes of Autologous Fat Grafting After Breast Conserving Surgery in Iraqi Women A Prospective Cohort Study

Abstract

Autologous fat grafting may correct residual contour defects after breast-conserving treatment, but prospective outcome data from Iraq are limited. This single-center prospective cohort evaluated volume retention, patient-reported outcomes, complications, imaging findings, and oncologic events in 42 Iraqi women after partial mastectomy. Participants were enrolled at Ghazi Al-Hariri Hospital of Surgical Specialties, Baghdad Medical City, between January 2022 and December 2023, underwent grafting at least six months after completion of radiotherapy, and were followed for 12 months after grafting. Harvested abdominal or thigh fat was centrifuged and injected in multiple tissue planes. Mean injected volume was 85.3 ± 22.7 mL, and reported 12-month retention was 68.4% ± 9.3%. BREAST-Q breast satisfaction increased from 42.1 ± 8.9 to 81.3 ± 10.2, and psychosocial well-being from 39.5 ± 7.6 to 78.9 ± 9.8 (both p < .001). Recorded minor events included oil cysts (4.8%), fat necrosis (2.4%), contour asymmetry (7.1%), and benign calcifications (9.5%). No graft-related BI-RADS 4–5 finding was recorded. No local recurrence occurred during follow-up; one patient developed distant metastases. The findings indicate favorable 12-month reconstructive outcomes in selected patients. The small uncontrolled cohort, reporting limitations, and short follow-up preclude conclusions about long-term oncologic safety or comparative effectiveness.