Does Fat Grafting Replacement to Reduce Implant Size Decrease Radiotherapy-related Complications in Prepectoral Expander-to-Implant Breast Reconstruction?

We congratulate the authors of the article Fat Graft Replacement for Reducing Implant Size May Decrease Radiotherapy-related Complications in Prepectoral Expander-to-Implant Breast Reconstruction for the originality of the concept and the methodology of their research.1 In this study, the authors investigated postradiotherapy complications in 2 groups of patients undergoing expander-to-implant change after irradiation. In the first group, patients underwent direct replacement of the prepectoral tissue expander with a definitive implant in a single stage, whereas in the second group patients received 2 sessions of fat grafting before the expander-to-implant exchange. The reported results show a reduction in complication rates in the group that underwent fat grafting before implant replacement.1 We find the results of this study interesting and, to some extent, predictable, because the potential regenerative effect of fat grafting has largely been described; however, we believe that several clarifications could further enhance the significance and reconsideration of the findings.2