Background: Autologous fat grafting is increasingly used in irradiated postmastectomy tissues, but objective imaging-based data describing structural remodeling remain limited. Objective: This pilot study aimed to evaluate ultrasound detectable structural changes following autologous fat grafting in irradiated postmastectomy chest wall tissues. Methods: This prospective pilot study included five female patients with prior radical mastectomy and adjuvant chest wall radiotherapy who underwent a single-session of autologous fat grafting. High-resolution ultrasound was performed preoperatively and at 3–5 months postoperatively using a 12 MHz linear probe. Parameters evaluated included hypodermal thickness, echogenicity (hyperechoic versus hypoechoic patterns), fascial definition, and fibrotic patterns. Results: All patients demonstrated a consistent postoperative increase in hypodermal thickness. Preoperative compact, hyperechogenic architecture transitioned to heterogeneous hypoechogenic patterns suggestive of viable adipose tissue integration consistent with viable adipose tissue. Fascial planes became more clearly defined in four patients. No necrosis, oil cysts, or fluid collections were detected. Conclusions: In this pilot cohort, ultrasound detected consistent postoperative changes in hypodermal thickness, echogenicity, and fascial definition following autologous fat grafting. These findings support the feasibility of ultrasound for the non-invasive assessment of post-radiotherapy structural tissue changes.

The sural nerve grafting plays a crucial role in the repair of peripheral nerve impairments when tension-free neurorrhaphy is unfeasible. The sural nerve is frequently utilized in sensory and mixed nerve repairs because of its anatomical reliability, sensory characteristics, and low donor site morbidity. This article critically reviews the current knowledge in the field and examines the anatomical and histological features of the sural nerve, along with contemporary harvesting techniques and clinical applications. High-resolution ultrasound (US) is highlighted as a non-invasive, real-time instrument for preoperative preparation, intraoperative mapping, and postoperative assessment. Ultrasonography enhances procedural precision, resulting in superior outcomes and less complications. Given the constraints of sural nerve grafts, alternative solutions such processed allografts and synthetic guidance are being evaluated.

Radiation-associated soft tissue fibrosis represents a progressive structural remodeling process characterized by extracellular matrix accumulation, septal thickening, and reduced tissue compliance, which complicates reconstructive interventions. Reliable longitudinal experimental frameworks capable of non-invasive structural monitoring remain limited. This study aimed to develop and implement a standardized ultrasonographic protocol for the evaluation of bleomycin-induced subcutaneous fibrosis and to assess remodeling dynamics following autologous fat grafting in a rat model. Twenty-two adult female Wistar rats were included. Subcutaneous fibrosis was induced using submaximal bleomycin administration (1 mg/kg/day for three consecutive days). High-frequency ultrasonography (12 MHz) was performed at baseline (Day 0), post-bleomycin (Day 17), and post-lipofilling (Day 31). A predefined semi-quantitative 0–3 scoring system was applied to characterize global echogenicity, septal thickening, and architectural organization. At Day 17, all animals demonstrated structural alteration with a mean score of 2.15 ± 0.58. At Day 31, the mean score decreased to 1.50 ± 0.50, with complete disappearance of high-grade architectural disorganization (score 3). Focal hypoechoic areas consistent with graft integration were observed in 88.9% of animals without ultrasonographic signs of necrosis or fluid collection. This standardized imaging-based framework enables reproducible longitudinal monitoring of early-stage subcutaneous fibrotic remodeling and provides a non-invasive tool for evaluating regenerative interventions in translational soft tissue engineering research.

Background/Objectives: Radiotherapy of the chest wall after mastectomy frequently leads to fibrosis, reduced tissue elasticity, erythema, pain and chronic skin-related symptoms that complicate reconstructive strategies. Autologous fat grafting has been proposed as a regenerative option for radiation induced soft tissue damage, but clinical data focused on patient-reported symptoms remain limited. The objective of this study was to describe symptomatic and clinical changes after autologous fat grafting in irradiated postmastectomy chest wall tissue. Methods: This pilot observational study included five female patients with a history of mastectomy followed by adjuvant chest wall radiotherapy. All patients underwent a single session of standard autologous fat grafting without adipose derived stem cell enrichment. Patient-reported symptoms, including pruritus, local discomfort, burning sensation and erythema, were recorded preoperatively and at six months using a standardized 0 to 5 scale. Scar pliability was assessed by two experienced physicians using the same scale. Only descriptive statistical analysis was performed. Results: All patients demonstrated lower postoperative symptom scores at six months. Mean reductions were observed for erythema (71.4 percent), burning sensation (61.1 percent) and pruritus (57.1 percent). Local discomfort decreased by 33.3 percent. Mean scar pliability scores increased from 2.2 to 3.2. No postoperative complications, such as infection, fat necrosis or oil cyst formation, were recorded. All patients completed the six month follow up. Conclusions: In this small pilot observational study, autologous fat grafting was well tolerated and associated with descriptive improvement of patient-reported symptoms and scar pliability in irradiated postmastectomy chest wall tissue. These findings suggest a potential symptomatic benefit of fat grafting, while larger studies with objective imaging and histological correlation are required to confirm efficacy and durability.