Department of Aesthetic and Plastic Surgery, Sana Klinikum Hameln Pyrmont, St. Maur Platz 1, 31785, Hameln, Germany.
Aesthetic Plast Surg. 2013 Apr;37(2):380-7. doi: 10.1007/s00266-012-0046-4. Epub 2013 Jan 26.
Autologous fat transplantation has gained great recognition in aesthetic and reconstructive surgery. Two main aspects are of predominant importance for progress control after autologous fat transplantation to the breast: quantitative information about the rate of fat survival in terms of effective volume persistence and qualitative information about the breast tissue to exclude potential complications of autologous fat transplantation. There are several tools available for use in evaluating the rate of volume survival. They are extensively compared in this review. The anthropometric method, thermoplastic casts, and Archimedes' principle of water displacement are not up to date anymore because of major drawbacks, first and foremost being reduced reproducibility and exactness. They have been replaced by more exact and reproducible tools such as MRI volumetry or 3D body surface scans. For qualitative and quantitative progress control, MRI volumetry offers all the necessary information: evaluation of fat survival and diagnostically valuable imaging to exclude possible complications of autologous fat transplantation. For frequent follow-up, e.g., monthly volume analysis, repeated MRI exams would not be good for the patient and are not cost effective. In these cases, 3D surface imaging is a good tool and especially helpful in a private practice setting where fast data acquisition is needed. This tool also offers the possibility of simulating the results of autologous fat transplantation.
This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
摘要:自体脂肪移植在美容和重建手术中得到了广泛的认可。对于自体脂肪移植到乳房后的进展控制,有两个主要方面非常重要:一是自体脂肪有效体积保持率的定量信息,二是乳房组织的定性信息,以排除自体脂肪移植的潜在并发症。有几种工具可用于评估体积存活率。本文对这些工具进行了广泛比较。人体测量法、热塑模型和阿基米德的排水原理由于存在主要缺陷,如可重复性和准确性降低,已经不再适用。它们已经被更精确和可重复的工具所取代,如 MRI 体绘制或 3D 体表面扫描。对于定性和定量的进展控制,MRI 体绘制提供了所有必要的信息:评估脂肪存活率和具有诊断价值的成像,以排除自体脂肪移植的潜在并发症。对于频繁的随访,例如每月的体积分析,重复进行 MRI 检查对患者不利,也不具有成本效益。在这种情况下,3D 表面成像就是一种很好的工具,尤其是在私人诊所中,需要快速获取数据时,它特别有帮助。该工具还可以模拟自体脂肪移植的结果。
证据等级:本杂志要求作者为每篇文章分配一个证据等级。有关这些循证医学评级的完整描述,请参考目录或在线作者指南 www.springer.com/00266 。