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[经皮筋膜切开术以改善脂肪移植至乳房]

[Percutaneous fasciotomies to improve fat grafting into the breast].

作者信息

Ho Quoc C, Michel G, Dlimi C, Gourari A, Meruta A, Delay E

机构信息

Département de chirurgie plastique et reconstructrice, centre régional Léon-Bérard, 28, rue Laennec, 69008 Lyon, France.

Département de chirurgie plastique et reconstructrice, centre régional Léon-Bérard, 28, rue Laennec, 69008 Lyon, France.

出版信息

Ann Chir Plast Esthet. 2014 Apr;59(2):130-5. doi: 10.1016/j.anplas.2013.08.008. Epub 2013 Sep 25.

Abstract

INTRODUCTION

Breast reconstruction or for breast deformities is a difficult challenge to get excellent results. Lipomodeling technique can improve thoracic malformations and breast deformities. Percutaneous fasciotomies can be an excellent tool for recipient site improvement. The aim of this study is to discuss interest of percutaneous needle fasciotomies with fat grafting into breast surgery.

MATERIAL AND METHODS

We have realized a retrospective study with fat transfer into the breast surgery. Recipient site prepared fasciotomies during fat grafting surgical procedure. Fat was harvested and centrifugated. Fat was injected into breast reconstructions or thoracic malformations. We did notice: population (age, BMI, uni/bilateral breasts), surgical procedure (mean sessions number, mean fat transfer). Aesthetic aspects of breasts were rated by both surgeon and patient: skin improvement, volume and shape of breast. Each complication was noticed: tissue wounds, scar evolution, hematoma, infection.

RESULTS

We started a retrospective study between 2006 and 2011. One thousand patients were treated with fasciotomies and fat grafting during the same procedure. Main indications were breast reconstruction with latissimus dorsi flap, breast implant reconstruction, breast cancer conservative surgeries, tuberous breast and Poland syndrom. Sessions number expected was between 1 and 3. No complication has been noticed, except 1 tissular wound that needed a medical treatment to solve the problem.

CONCLUSION

Fasciotomie is an indispensable complement tool for fat grafting. It is a safe and reliable technique. It improves aesthetic outcomes of breast surgery. Main indications of fasciotomies with fat grafting are breast reconstruction with radiation, breast cancer conservative surgery, and tuberous breast. Percutaneous fasciotomies provide excellent aesthetic result with no scar. They improve the shape of the breast with long-standing result.

摘要

引言

乳房重建或修复乳房畸形是一项艰巨挑战,要取得理想效果并非易事。脂肪重塑技术可改善胸廓畸形和乳房畸形。经皮筋膜切开术可能是改善受区的一种理想工具。本研究旨在探讨经皮穿刺针筋膜切开术联合脂肪移植在乳房手术中的应用价值。

材料与方法

我们对乳房手术中脂肪移植进行了一项回顾性研究。在脂肪移植手术过程中对受区进行筋膜切开术。采集脂肪并离心。将脂肪注入乳房重建或胸廓畸形部位。我们记录了:人群(年龄、体重指数、单侧/双侧乳房)、手术过程(平均手术次数、平均脂肪移植量)。由外科医生和患者对乳房的美学方面进行评分:皮肤改善情况、乳房体积和形状。记录每种并发症:组织创伤、瘢痕演变、血肿、感染。

结果

我们于2006年至2011年开展了一项回顾性研究。1000例患者在同一手术过程中接受了筋膜切开术和脂肪移植。主要适应证为背阔肌肌皮瓣乳房重建、乳房假体植入重建、乳腺癌保乳手术、漏斗胸和波兰综合征。预期手术次数为1至3次。除1例需要药物治疗来解决问题的组织创伤外,未发现其他并发症。

结论

筋膜切开术是脂肪移植不可或缺的辅助工具。它是一种安全可靠的技术。它改善了乳房手术的美学效果。筋膜切开术联合脂肪移植的主要适应证为放疗后乳房重建、乳腺癌保乳手术和漏斗胸。经皮筋膜切开术可提供无瘢痕的出色美学效果。它们能长期改善乳房形状。

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