Background Lymphedema remains a debilitating complication following axillary lymph node dissection (ALND) in breast cancer surgery, with limited effective preventive strategies available, particularly in low-resource settings. Dermofat graft (DFG) implantation, an autologous technique combining dermis and adipose tissue, has emerged as a potential method to restore tissue volume, and promote lymphangiogenesis. This study evaluates the feasibility, safety, and preliminary efficacy of DFG implantation in preventing lymphedema and reconstructing surgical defects following ALND in breast cancer patients. Methods A prospective case series was conducted involving seven female breast cancer patients (aged 44–66 years) undergoing modified radical mastectomy (MRM) or breast-conserving surgery (BCS) with ALND. Intraoperative DFGs harvested from the lower abdomen were implanted into axillary and/or breast defects. Outcomes included arm volume measurements (preoperatively and at 1, 3, and 6 months), incidence of lymphedema (International Society of Lymphology criteria), lymphoscintigraphy for lymphatic regeneration, and postoperative complications. Results Across all seven cases, no early-stage lymphedema (stage 0–II) was observed at six months postoperatively. Lymphoscintigraphy performed in four patients (57.1%) demonstrated new lymphatic vessel formation. Minor complications included seroma with partial fat lysis (n = 2) and transient fever (n = 1), all of which resolved without long-term sequelae. Cosmetic outcomes were favorable, with improved axillary contour and preserved breast symmetry in BCS cases. Conclusion Dermofat graft implantation is a feasible and safe technique that may simultaneously prevent lymphedema and enhance reconstructive outcomes in breast cancer surgery. DFG offers a resource-efficient alternative to microsurgical procedures, particularly valuable in low- and middle-income settings.
Suyatno et al. (Sun,) studied this question.