Cai L, Han X F, Wang B Q, Li F C
Department of Body Contouring and Liposuction Center of Plastic Surgery, Hospital of Peking Union Medical College, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100144, China.
Zhonghua Wai Ke Za Zhi. 2017 Sep 1;55(9):696-701. doi: 10.3760/cma.j.issn.0529-5815.2017.09.011.
To observe the outcome of breast reconstruction with autologous fat grafting in the patients following treatment for breast cancer. The clinical data of 22 patients after breast cancer modified radical mastectomy with fat grafting for breast reconstruction from January 2012 to March 2015 at Department of Body Contouring and Liposuction Center of Plastic Surgery, Hospital of Peking Union Medical College were analyzed retrospectively. The age of 22 patients (all female) was 28 to 54 years. Fifteen patients were performed breast modified radical mastectomy 5 to 16 year ago without radiotherapy, 7 patients were performed breast modified radical mastectomy following regular radiotherapy 2 years ago. Low negative pressure liposuction technical was applied to harvest fat tissue for 400 to 800 ml which was filtrated and purified by cotton pad method in low temperature environment. Fat grafting was performed with multi-level and multi-tunnel and in multi-point injection ways. All patients were followed up by regular imaging evaluation with MRI or ultrasonography after operation every 3 months. All breast reconstruction were successfully performed in 22 patients, no severe complications occurred. Among 15 patients without radiotherapy, 12 patients were performed with autologous fat grafting for breast reconstruction, 3 patients with prosthetic implantation for breast augmentation after autologous fat grafting. Among 7 patients with radiotherapy, 6 patients were performed with autologous fat grafting for breast reconstruction, 1 patient with prosthetic implantation for breast augmentation after autologous fat grafting. The volume of fat grafting was 104 to 380 ml. It took 2.5 hours to finish the operation including 1.0 to 1.5 hours for liposuction and 40 minutes for fat grafting. Next fat grafting were performed after 3 months. The fat of the breast were survived well detecting by MRI, only 1 patient had a cystic nodule which had been resected during nipple reconstruction. Ultrasonography screened several cystic nodules with the major axis of 0.1 to 0.2 cm in the breast, which couldn't be found by palpating in 18 patients. The patients were followed up for 18 to 36 months, the outcome were satisfactory. Autologous fat grafting for breast reconstruction simplifies the operation program with satisfied results and avoids the complications of breast reconstruction with skin flap.
观察乳腺癌患者自体脂肪移植乳房重建的效果。回顾性分析2012年1月至2015年3月在北京协和医院整形外科体型塑造与吸脂中心行乳腺癌改良根治术后采用脂肪移植进行乳房重建的22例患者的临床资料。22例患者（均为女性）年龄28～54岁。15例患者于5至16年前行乳房改良根治术，未行放疗；7例患者于2年前行常规放疗后行乳房改良根治术。采用低负压吸脂技术获取400～800ml脂肪组织，在低温环境下用棉垫法进行过滤和纯化。脂肪移植采用多层次、多隧道、多点注射方式。术后每3个月定期行MRI或超声影像学评估对所有患者进行随访。22例患者乳房重建均成功，未发生严重并发症。15例未放疗患者中，12例行自体脂肪移植乳房重建，3例行自体脂肪移植后假体植入隆乳。7例放疗患者中，6例行自体脂肪移植乳房重建，1例行自体脂肪移植后假体植入隆乳。脂肪移植量为104～380ml。手术时间2.5小时，其中吸脂1.0～1.5小时，脂肪移植40分钟。3个月后进行再次脂肪移植。MRI检查显示乳房脂肪存活良好，仅1例患者在乳头重建时切除了一个囊性结节。超声检查发现乳房内有几个长径0.1～0.2cm的囊性结节，18例触诊未触及。患者随访18～36个月，效果满意。自体脂肪移植乳房重建简化了手术程序，效果满意，避免了皮瓣乳房重建的并发症。
