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Lipofilling use has become a revolutionary technique for the correction of breast defect including breast cancer sequelae. The potential risk that progenitor cells included in fat graft tissue may contribute to disease progression by stimulation of residuary breast cancer cells in a tumor bed has set alarms regarding its safety. The aim of this study was to identify lipofilling interference over breast recurrence in patients with cancer history.We reviewed 205 patients with fat grafting reconstruction after breast cancer surgery performed in our institution between the years 2007 and 2015. For comparative analysis, we selected 2 matched control patients with similar characteristics who did not undergo any lipofilling procedure.No significant differences in recurrence were observed in patients who had lipofilling compared with controls, local (2.4% vs 3.2%, P = 0. 485), regional (1.0 vs 0.7, P = 0.968), and distant (3.4% vs 3.9%, P = 0.590) recurrence. An increased risk of locoregional recurrence (P = 0.014) was detected when lipofilling took place within the first 36 months after cancer surgery.This study provides patients and surgeons with the confidence to keep using lipofilling reconstruction in women with breast cancer history when it is performed in a hospital setting by trained surgeons.