Costantino A, Fioramonti P, Ciotti M, Onesti M G
University of Rome, Italy.
G Chir. 2012 May;33(5):186-90.
In recent years, lipofilling has established itself as one of the most effective and least invasive techniques to treat connective dystrophy subsequent to radiotherapy. We report the case of a patient diagnosed with intraductal carcinoma of the right breast in 1996, at the age of 41. The patient underwent quadrantectomy with ipsilateral axillary lymph node dissection and adjuvant chemotherapy and radiotherapy. Four years later, a recurrence led the patient to undergo a subcutaneous mastectomy and immediate reconstruction, involving the submuscular insertion of a permanent implant. In 2007 the patient suffered both radiodermatitis and capsular contracture around the implant, causing constant pain and significant functional limitation. She first took a leukotriene inhibitor (Zafirlukast, 20 mg daily for 8 months) to reduce the capsular contracture. She then underwent lipofilling (Coleman's technique) of the area affected by radiodermatitis, in which the skin was considerably thinned and visibly ischemic. A second session followed four months later. Clinical, photographic and ultrasound examination revealed clear and lasting thickening of the superficial tissues, increased coverage of the implant, and reduced skin discoloration and tension.
近年来，脂肪填充已成为治疗放疗后结缔组织营养不良最有效且侵入性最小的技术之一。我们报告一例患者，该患者于1996年41岁时被诊断为右乳导管内癌。患者接受了象限切除术及同侧腋窝淋巴结清扫术，并进行了辅助化疗和放疗。四年后，复发导致患者接受皮下乳房切除术及即刻重建，包括在胸大肌下植入永久性假体。2007年，患者出现放射性皮炎及假体周围包膜挛缩，导致持续疼痛和明显的功能受限。她首先服用白三烯抑制剂（扎鲁司特，每日20mg，共8个月）以减轻包膜挛缩。然后，她接受了对受放射性皮炎影响区域的脂肪填充（科尔曼技术），该区域皮肤明显变薄且可见缺血。四个月后进行了第二次治疗。临床、照片及超声检查显示，浅表组织明显且持久增厚，假体覆盖增加，皮肤变色及张力减轻。
