Role of the Stromal Vascular Fraction in Breast Reconstruction after Breast Cancer Surgery: A Review

Breast cancer is among the main reasons for most cancer-associated loss of life in women worldwide. The use of autologous lipotransfer has become increasingly popular for breast reconstruction. With the emerging data on the efficacy of stromal vascular fraction (SVF) in oncological safety and survival rates, although many studies have focused on improving the preservation of fat graft volume with this material, questions regarding safety and efficacy still remain. The present study aimed to determine the advantages and disadvantages of SVF in fat grafting, especially in its preservation.

Our search was conducted on published research between 2000 and 2022 using several international databases, including Scopus, PubMed, Web of Science, and Google Scholar. We also reviewed additional evidence from relevant published articles.

Although the SVF is easier to isolate than adipose-derived mesenchymal stem cells (ADSCs), it contains a heterogeneous mix of cells. The SVF may act through angiogenesis promotion by endothelial/progenitor cells and immunomodulation by ADSCs. The SVF-enhanced fat grafts improve volume retention in animal models. Although limited clinical data supports improved breast augmentation with SVF without increased cancer recurrence, optimal SVF isolation and cell ratios require further research. 

 Based on the obtained findings, although SVF shows promise to improve fat grafting outcomes in breast reconstruction, more clinical studies on oncologic safety and technical considerations are warranted.