Department of Specialistic Surgical and Anesthesiologic Sciences, Università degli Studi di Bologna, Bologna, Italy.
Aesthetic Plast Surg. 2011 Oct;35(5):703-8. doi: 10.1007/s00266-011-9670-7. Epub 2011 Feb 27.
When prosthetic reconstruction fails, and in the case of absolute contraindications to flaps use, no common reconstructive option is available.
A large irradiated breast was reconstructed using only fat grafts (9 sessions) after prosthetic reconstruction failure (exposure of implant) due to absolute contraindications to general anesthesia and unavailability of large flaps. During the first four sessions small volumes were implanted in the extremely rigid and retracted tissues with regenerative purposes. Larger volumes were implanted during the last five sessions to improve volume and shape.
A pleasant aesthetic result was achieved. Tissue regeneration with good vascular support was evident at ultrasonography and magnetic resonance. Histologic and ultrastructural examination of the new tissue showed normal adipose tissue with cell and vasculostromal maturation aspects. No degenerative or inflammatory aspects were present.
Fat graft transplantation can be a reliable and safe option for breast reconstruction in selected patients.
当假体重建失败，且存在使用皮瓣的绝对禁忌证时，通常没有可供选择的重建方法。
由于对全身麻醉存在绝对禁忌证且无法使用大型皮瓣，一名患者在假体重建失败（植入物外露）后，仅使用脂肪移植（共 9 次）进行了大型受照射乳房的重建。在前 4 次治疗中，为了再生目的，向非常僵硬和回缩的组织中少量植入较小体积的脂肪。在最后 5 次治疗中，植入更大体积的脂肪以改善体积和形状。
获得了令人满意的美学效果。超声和磁共振成像显示，组织再生有良好的血管支持。对新组织的组织学和超微结构检查显示，正常脂肪组织存在细胞和血管基质成熟方面。没有退行性或炎症方面的表现。
脂肪移植移植对于某些患者来说是一种可靠且安全的乳房重建选择。
