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自体脂肪移植至重建乳房:后天性轮廓畸形的处理

Autologous fat grafting to the reconstructed breast: the management of acquired contour deformities.

作者信息

Kanchwala Suhail K, Glatt Brian S, Conant Emily F, Bucky Louis P

机构信息

Philadelphia, Pa.; and Morristown, N.J. From the University of Pennsylvania and private practice.

出版信息

Plast Reconstr Surg. 2009 Aug;124(2):409-418. doi: 10.1097/PRS.0b013e3181aeeadd.

Abstract

BACKGROUND

Autologous fat grafting has become a workhorse for soft-tissue augmentation throughout the body. In the reconstructed breast, autologous fat grafting is a useful tool for managing secondary contour deformities. The authors have categorized these deformities into three types: type 1 deformities are step-off deformities between the chest wall/reconstructed breast interface, type 2 deformities result from intrinsic deficiencies within a flap such as fat necrosis, and type 3 deformities are the result of extrinsic factors such as postoperative irradiation.

METHODS

The authors conducted a detailed retrospective review of 110 patients who have received fat grafting to the reconstructed breast for the management of contour deformities. In addition, the authors reviewed the recent literature describing the use of autologous fat grafting to the breast. Particular attention has been placed on the concerns of oncologic surveillance in reconstructed breasts that have undergone fat grafting.

RESULTS

The authors have had relative success in the treatment of patients who will require postoperative irradiation and even those who have rippling surrounding an implant.

CONCLUSIONS

Autologous fat grafting represents an important tool for the management of secondary contour deformities of the reconstructed breast. Fat grafting is a simple, safe, and effective treatment option, with low morbidity.

摘要

背景

自体脂肪移植已成为全身软组织填充的常用方法。在乳房重建中,自体脂肪移植是处理继发轮廓畸形的有用工具。作者将这些畸形分为三种类型:1型畸形是胸壁/重建乳房界面处的台阶样畸形,2型畸形是皮瓣内固有缺陷(如脂肪坏死)导致的,3型畸形是术后放疗等外在因素导致的。

方法

作者对110例因处理轮廓畸形而接受乳房重建脂肪移植的患者进行了详细的回顾性研究。此外,作者还回顾了近期描述自体脂肪移植用于乳房的文献。特别关注了接受脂肪移植的重建乳房的肿瘤监测问题。

结果

作者在治疗需要术后放疗的患者甚至那些植入物周围有波纹的患者方面取得了相对成功。

结论

自体脂肪移植是处理乳房重建继发轮廓畸形的重要工具。脂肪移植是一种简单、安全、有效的治疗选择,发病率低。

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