Voglimacci Marie, Garrido Ignacio, Mojallal Ali, Vaysse Charlotte, Bertheuil Nicolas, Michot Audrey, Chavoin Jean Pierre, Grolleau Jean Louis, Chaput Benoit
Drs Voglimacci and Chaput are Staff Surgeons and Drs Garrido, Grolleau, and Chavoin are Professors in the Department of Plastic, Reconstructive, Burns, and Aesthetic Surgery at the University of Toulouse Rangueil, France. Dr Mojallal is a Professor in the Department of Plastic, Aesthetic, and Reconstructive Surgery at Edouard Herriot Hospital, University of Lyon, France. Dr Vaysse is a Staff Surgeon in the Department of Surgery and Gynecology and a member of the Faculty of Medicine at the University of Toulouse Rangueil, France. Dr Bertheuil is a Staff Surgeon in the Department of Plastic, Reconstructive, and Aesthetic Surgery at the Hospital Sud, University of Rennes 1, France. Dr Michot is a Staff Surgeon in the Department of Surgical Oncology at the Institut Bergonié and a member of the Faculty of Medicine at the University of Bordeaux Segalen, France.
Aesthet Surg J. 2015 May;35(4):378-93. doi: 10.1093/asj/sjv030.
Breast augmentation is one of the most popular aesthetic surgical procedures. The only potential alternative is autologous fat grafting (AFG), which is not new in principle. This procedure has been used on native breasts since 2009, following the recommendations of some learned societies.
We performed a systematic review to determine the current worldwide status of fat grafting for aesthetic breast augmentation.
A systematic review of the literature following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis criteria was conducted using the PubMed, EmBASE, and Cochrane library databases. This protocol was registered at the National Institute for Health Research, Prospective Register of Systematic Reviews.
A total of 42 articles published between 1987 and July 2014 were included. Most of the studies had a low level of evidence, with only one level 2 study, published by Spear (2014), a prospective cohort study which included 10 patients. The publications were from North America, Europe, and Asia. The indications were aesthetic augmentation (92.4%) and congenital malformation (7.6%). Two cases of cancer were reported among the 2023 patients included (0.09%), with a mean follow-up of 22 months, although the follow-up was insufficient for medium- and long-term cancer diagnoses.
AFG seems to be a major tool in this field, but we must remain cautious about its systematization for this indication. Preoperative patient selection is essential but underreported. AFG appears particularly relevant in breast malformations. We believe that this method should be practiced within the scope of a national or international registry with proper follow-up of patients.
隆胸是最受欢迎的美容外科手术之一。唯一可能的替代方法是自体脂肪移植（AFG），这在原则上并非新技术。自2009年起，根据一些学术团体的建议，该手术已应用于天然乳房。
我们进行了一项系统评价，以确定目前全球范围内用于美容隆胸的脂肪移植现状。
按照系统评价和Meta分析的首选报告项目标准，使用PubMed、EmBASE和Cochrane图书馆数据库对文献进行系统评价。该方案已在英国国家卫生研究院前瞻性系统评价注册库注册。
共纳入1987年至2014年7月发表的42篇文章。大多数研究证据水平较低，只有Spear（2014年）发表的一项2级研究，即一项纳入10例患者的前瞻性队列研究。这些出版物来自北美、欧洲和亚洲。适应症为美容隆胸（92.4%）和先天性畸形（7.6%）。在纳入的2023例患者中报告了2例癌症（0.09%），平均随访22个月，不过随访时间不足以进行中长期癌症诊断。
自体脂肪移植似乎是该领域的一种主要手段，但我们必须对其用于该适应症的系统化保持谨慎。术前患者选择至关重要，但报道不足。自体脂肪移植在乳房畸形方面似乎特别适用。我们认为，这种方法应在国家或国际登记系统的范围内实施，并对患者进行适当随访。
