Kerfant Nathalie, Henry Anne-Sophie, Hu Weiguo, Marchac Alexandra, Auclair Eric
Brest and Paris, France.
From the Service de Chirurgie Plastique, Reconstructrice, et Esthétique, CHRU de Brest; and Clinique Spontini.
Plast Reconstr Surg. 2017 May;139(5):1080e-1085e. doi: 10.1097/PRS.0000000000003299.
Composite breast augmentation with fat grafting and an implant has become very popular in the past 5 years. This achieves the core volume projection of an implant complemented by the natural appearance and feel of fat. However, no study has looked at the complications and reoperation rates of this technique.
A retrospective chart review examined all patients who underwent the combined use of an implant and fat grafting for primary breast augmentation.
The study identified 156 patients between 2007 and 2013. The mean patient age was 31.7 years and the average body mass index was 18.85 kg/m. The average implant size was 252 cc. Patients received a mean of 126 cc of fat (range, 30 to 250 cc) in subcutaneous soft tissue. Follow-up averaged 22.25 months (range, 1 to 86 months). The total complication rate was 7.7 percent and the reoperation rate was 9.94 percent. Baker grade II/III contracture was the most common complication [Baker grade II, n = 4 (2.56 percent); Baker grade III, n = 2 (2 percent)], followed by infections [n = 2 (1.28 percent)], hematoma [n = 2 (1.28 percent)], and malrotation [n = 1 (0.64 percent)]. Delayed reoperation was performed in nine patients (9.94 percent) after a mean interval of 31.7 months. Two patients who developed Baker grade III contractures needed surgery to correct the problem. Three cases (1.92 percent) required additional fat grafting for insufficient soft-tissue coverage. The mean volume of fat reinjection was 170 cc.
Composite breast augmentation is a valuable, stable, reliable technique in breast aesthetic surgery with good, natural-appearing results. It provides long-term aesthetic benefits and avoids the submuscular plane.
CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, IV.
在过去5年中，脂肪移植与植入物联合的复合式隆乳术已变得非常流行。这实现了植入物的核心体积突出效果，并辅以脂肪的自然外观和触感。然而，尚无研究关注该技术的并发症和再次手术率。
一项回顾性病历审查研究了所有接受植入物与脂肪移植联合用于初次隆乳术的患者。
该研究纳入了2007年至2013年间的156例患者。患者平均年龄为31.7岁，平均体重指数为18.85kg/m。平均植入物大小为252cc。患者在皮下软组织中平均接受了126cc脂肪（范围为30至250cc）。随访平均为22.25个月（范围为1至86个月）。总并发症发生率为7.7%，再次手术率为9.94%。贝克II/III级挛缩是最常见的并发症[贝克II级，n = 4（2.56%）；贝克III级，n = 2（2%）]，其次是感染[n = 2（1.28%）]、血肿[n = 2（1.28%）]和旋转不良[n = 1（0.64%）]。9例患者（9.94%）在平均间隔31.7个月后进行了延迟再次手术。2例出现贝克III级挛缩的患者需要手术纠正问题。3例（1.92%）因软组织覆盖不足需要额外的脂肪移植。脂肪再次注射的平均体积为170cc。
复合式隆乳术在乳房美容手术中是一种有价值、稳定、可靠的技术，效果良好且外观自然。它提供长期的美学益处并避免了胸大肌下平面。
临床问题/证据级别：治疗性，IV级。
