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采用水辅助吸脂采集自体脂肪移植修复乳房假体包膜挛缩的一期修复手术（“BEAULI 法”）

One stage rescue procedure after capsular contracture of breast implants with autologous fat grafts collected by water assisted liposuction ("BEAULI Method").

作者信息

Ueberreiter Klaus, Tanzella Ursula, Cromme Felix, Doll Dietrich, Krapohl Björn Dirk

机构信息

Park-Klinik Birkenwerder, Fachklinik für Plastische und Ästhetische Chirurgie, Birkenwerder, Germany.

Bundeswehrkrankenhaus Berlin, Department für Plastische Chirurgie und Handchirurgie, Berlin, Germany.

出版信息

GMS Interdiscip Plast Reconstr Surg DGPW. 2013 Jan 30;2:Doc03. doi: 10.3205/iprs000023. eCollection 2013.

DOI:10.3205/iprs000023
PMID:26504697
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC4582487/
Abstract

With increasing number of patients with silicone implants for breast augmentation or reconstruction we are confronted with more and more cases of capsular contracture. Not every case is resolved by resection of the capsule and exchange of implants. Many patients rather bear the consequences of severe fibrosis than to have their implants removed. The one stage procedure of implant removal and lipofilling proved to be highly efficient with good to excellent results and high patient satisfaction. Between January 2008 and October 2012 a total of 64 patients (124 breasts) with capsular fibrosis Baker III to IV were treated with autologous fat grafts collected with the body-jet(®) by water-assisted liposuction ("BEAULI Method"). Magnetic resonance imaging (MRI) of the breasts was performed in 5 patients preoperatively and 6 month postoperatively, a clinical examination and photo documentation of all patients was done on day 1 and after 4 weeks, 12 weeks and 6 months postoperatively. The procedure included implant removal and lipofilling of the subcutaneous and intramuscular space in a single procedure by means of the BEAULI Method. The average gross amount of grafted fat was 260 ml. The average drainage time was one day. The shape of the breast changed to a more natural and ptotic form. Negative side effects like oily cysts or infections were not observed. The time of the overall procedure including liposuction was 70±15 min. Reoccurring capsular contracture is one of the hazards in plastic surgery. Until now the treatment of choice after more than two failed implant changes combined with resection of the capsule is usually the final removal of implants with or without possible additional autologous tissue transfer (microvascular flaps). We could add a relatively simple and efficient procedure to resolve and improve those cases by autologous fat transfer using water-assisted liposuction and the BEAULI Method.

摘要

随着接受硅胶植入进行隆胸或乳房重建的患者数量不断增加，我们面临着越来越多的包膜挛缩病例。并非每个病例都能通过切除包膜和更换植入物来解决。许多患者宁愿承受严重纤维化的后果，也不愿取出植入物。植入物取出和脂肪填充的一期手术被证明效率很高，效果良好至极佳，患者满意度也很高。在2008年1月至2012年10月期间，共有64例（124个乳房）患有贝克III至IV级包膜纤维化的患者接受了通过水辅助吸脂术（“BEAULI法”）使用Body-jet(®)收集的自体脂肪移植治疗。5例患者在术前和术后6个月进行了乳房磁共振成像（MRI）检查，所有患者在术后第1天、4周、12周和6个月进行了临床检查和照片记录。该手术通过BEAULI法在一次手术中完成植入物取出以及皮下和肌肉内间隙的脂肪填充。移植脂肪的平均总量为260毫升。平均引流时间为一天。乳房形状变得更加自然和下垂。未观察到油性囊肿或感染等负面副作用。包括吸脂在内的整个手术时间为70±15分钟。复发性包膜挛缩是整形手术中的风险之一。到目前为止，在两次以上更换植入物失败并结合包膜切除后，通常的治疗选择是最终取出植入物，可能还会进行或不进行额外的自体组织转移（微血管皮瓣）。我们可以通过使用水辅助吸脂术和BEAULI法进行自体脂肪移植，增加一种相对简单有效的方法来解决和改善这些病例。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c348/4582487/16e2ab3c160e/IPRS-02-03-g-013.jpg
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https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c348/4582487/bf7155e4e387/IPRS-02-03-g-011.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c348/4582487/90fad8d9eea9/IPRS-02-03-g-012.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c348/4582487/16e2ab3c160e/IPRS-02-03-g-013.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c348/4582487/ccaaf0a4a2e1/IPRS-02-03-t-001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c348/4582487/3689f734c2da/IPRS-02-03-g-001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c348/4582487/3bfe2c9dbeea/IPRS-02-03-g-002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c348/4582487/a6f8ca2e9ef9/IPRS-02-03-g-003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c348/4582487/e4a22184c290/IPRS-02-03-g-004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c348/4582487/49f7fe8722f2/IPRS-02-03-g-005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c348/4582487/8f7b902ec1cc/IPRS-02-03-g-006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c348/4582487/9645ce1603be/IPRS-02-03-g-007.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c348/4582487/609d9c42cb3f/IPRS-02-03-g-008.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c348/4582487/22c93cd2f16f/IPRS-02-03-g-009.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c348/4582487/81f7af7adef3/IPRS-02-03-g-010.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c348/4582487/bf7155e4e387/IPRS-02-03-g-011.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c348/4582487/90fad8d9eea9/IPRS-02-03-g-012.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c348/4582487/16e2ab3c160e/IPRS-02-03-g-013.jpg

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Plast Reconstr Surg. 2010 Sep;126(3):769-778. doi: 10.1097/PRS.0b013e3181e5f7bf.
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