Prepectoral breast reconstruction after total skin-sparing mastectomy using bolus injection of autologous fat

Objective. To develop and introduce into clinical practice the method of bolus fat injection for primary prepectoral breast reconstruction. Material and methods. Prepectoral reconstruction using bolus fat injection with delayed replacement with breast implant was applied to 20 patients who underwent subcutaneous mastectomy with axillary lymph dissection. Autologous fat bolus without subsequent replacement with implant during subcutaneous total mastectomy was performed in 32 patients (2021–2025). Surgery was regarded as a one-step reconstruction with fat bolus preservation. Results. We developed surgical technique for breast reconstruction with bolus fat injection. Bolus lipofilling is a simple and effective method for primary prepectoral breast reconstruction after skin-sparing mastectomy. Conclusion. Considering follow-up data in 2021–2025, we can confidently talk about safety of original method for life and health of patients. Fat bolus during prepectoral breast reconstruction can act as a temporary (with subsequent replacement with implant) and permanent shape- and volume-forming breast element. Fat bolus is a simple procedure not requiring special equipment and tools. This greatly simplifies its implementation in various clinics.