Reply to Klinger et al.

Concerning its use on irradiated expanders, who writes first described it2 (on this journal, in 2011) for patients undergoing unplanned postmastectomy radiotherapy (early breast cancers with specific risk factors), and later on in 2013 expanded the applications3 to patients where radiotherapy was planned in advance (advanced breast cancers). The rationale of our protocol, which we called “protective lipofilling”, was to protect the expanded skin from ulceration and other complications. As an adjunct to our protocol before second stage breast reconstruction, Klinger’s group also uses lipofilling during the second stage, a practice which we have adopted since their contribution in 20144. We know that this philosophy has gained wide acceptance in several breast centers in Italy, because of its great results in terms of reducing complications.