Composite breast reconstruction: Implant-based breast reconstruction with adjunctive lipofilling.

Autor: Sommeling CE; Department of Plastic and Reconstructive Surgery, University Hospital Ghent, Ghent, Belgium., Van Landuyt K; Department of Plastic and Reconstructive Surgery, University Hospital Ghent, Ghent, Belgium., Depypere H; Department of Gynaecology, University Hospital Ghent, Ghent, Belgium., Van den Broecke R; Department of Gynaecology, University Hospital Ghent, Ghent, Belgium., Monstrey S; Department of Plastic and Reconstructive Surgery, University Hospital Ghent, Ghent, Belgium., Blondeel PN; Department of Plastic and Reconstructive Surgery, University Hospital Ghent, Ghent, Belgium., Morrison WA; O'Brien Institute Dept. of St Vincent's Institute, Melbourne, Australia; University of Melbourne, Dept. of Surgery at St Vincent's Hospital, Melbourne, Australia; Faculty of Health Sciences, Australian Catholic University, Melbourne, Australia; Victorian State Government's Department of Innovation, Industry and Regional Development's Operational Infrastructure Support Program, Melbourne, Australia., Stillaert FB; Department of Plastic and Reconstructive Surgery, University Hospital Ghent, Ghent, Belgium. Electronic address: filip.stillaert@ugent.be.
Jazyk: angličtina
Zdroj: Journal of plastic, reconstructive & aesthetic surgery : JPRAS [J Plast Reconstr Aesthet Surg] 2017 Aug; Vol. 70 (8), pp. 1051-1058. Date of Electronic Publication: 2017 May 22.
DOI: 10.1016/j.bjps.2017.05.019
Abstrakt: Introduction: Options for breast reconstructions enclose autologous tissue transfers or implants. Fat grafting is gaining more interest in this specific field of breast surgery. This study concentrates on the technique and aesthetic results of breast reconstruction with fat grafts combined with implants, in women who have undergone total mastectomy.
Methods: Breast reconstructions (n = 23) was performed using a protocol of intratissular expansion with serial deflation-lipofilling. In order to achieve the best aesthetic outcome, an additional small implant was placed. A retrospective data analysis was performed. In all patients a tissue expander was placed at the time of mastectomy or after removal of a previous breast reconstruction. The mean of lipoaspirate material for the reconstruction was 333 mL (range 120-715 mL). To create an adequate volume of the reconstructed breast, a supplementary small implant was placed, with a mean volume of 222 mL (range 125-375 mL). The mean follow-up was 33 months (range 19-50 months).
Results: A MRI analysis was performed in eight patients at least 9 months after the last lipofilling procedure, demonstrating a mean of 171 mL (range 64-538 mL) of transferred fat, a mean fat survival of 53% and a volume ratio of fat graft/implant of 0.97 (range 0,3-3,8).
Conclusion: This composite technique of using autologous fat tissue and implants shows aesthetic pleasant results and must be considered as a valid alternative in a subset of patients. Further investigations to optimize the fat graft take must be encouraged.
(Copyright © 2017 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.)
Databáze: MEDLINE
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