Simonacci F, Grieco M P, Bertozzi N, Raposio E
G Chir. 2017 May-Jun;38(3):117-123. doi: 10.11138/gchir/2017.38.3.117.
Autologous fat transplantation is used after breast reconstruction to improve the breast profile. There are a variety of different methods used for fat harvesting, preparation, and reinjection. This study describes the specific techniques we used in this series of autologous fat transplantations in breast reconstruction patients and reports their outcomes compared with other studies in the literature.
At the University Hospital of Parma between May 2012 and December 2016, we performed 53 autologous fat transplantations for secondary breast reconstruction patients with an average age of 49 years (range: 34-65 y). A tumescent fluid (NaCl, epinephrine, and a local anaesthetic) was injected, and the lipoaspirate was harvested using a closed aspiration-injection system connected to a 50 ml syringe, a 4 mm infiltration cannula, and a -650 mmHg vacuum. The average amount of lipoaspirate obtained was 100 ml (range: 50-200 ml). Centrifugation of the lipoaspirate (3000 rpm for 3 min) was performed to isolate the adipose tissue (average amount obtained, 80 ml; range: 30-180 ml). Under local anaesthesia, the retrograde injection of thin layers of fat graft in multiple tunnels was performed in the subcutaneous and/or subglandular planes.
Average follow-up was six months. Comparable to other studies, our complication rate was 7.4% (n = 4/53) and included cyst formation at the injection site (n = 1/53) and hematoma at the donor site (n = 3/53). Repeat fat grafting was performed in 28.3% of patients (n = 15/53) due to fat graft resorption.
Autologous fat transplantation is a useful procedure for correcting irregularities in the breast contour in secondary breast reconstruction.
自体脂肪移植用于乳房重建后以改善乳房外形。脂肪获取、制备和再注射有多种不同方法。本研究描述了我们在这一系列乳房重建患者自体脂肪移植中所使用的具体技术,并报告了与文献中其他研究相比的结果。
2012年5月至2016年12月期间,我们在帕尔马大学医院对平均年龄49岁(范围:34 - 65岁)的二期乳房重建患者进行了53例自体脂肪移植。注射肿胀液(氯化钠、肾上腺素和局部麻醉剂),使用连接到50毫升注射器、4毫米浸润套管和 - 650毫米汞柱真空的封闭式抽吸 - 注射系统获取脂肪抽吸物。获得的脂肪抽吸物平均量为100毫升(范围:50 - 200毫升)。对脂肪抽吸物进行离心(3000转/分钟,持续3分钟)以分离脂肪组织(获得的平均量为80毫升;范围:30 - 180毫升)。在局部麻醉下,在皮下和/或腺下平面的多个隧道中逆行注射薄层脂肪移植物。
平均随访6个月。与其他研究相当,我们的并发症发生率为7.4%(n = 4/53),包括注射部位囊肿形成(n = 1/53)和供区血肿(n = 3/53)。由于脂肪移植物吸收,28.3%的患者(n = 15/53)进行了重复脂肪移植。
自体脂肪移植是矫正二期乳房重建中乳房轮廓不规则的一种有用方法。