Brondi Renata Suzuki, de Oliveira Vilmar Marques, Bagnoli Fábio, Mateus Evandro Falacci, Rinaldi José Francisco
From the Breast Surgery Department, Hospital Santa Casa de Misericórdia de São Paulo, São Paulo, Brazil.
Ann Plast Surg. 2019 Feb;82(2):152-157. doi: 10.1097/SAP.0000000000001764.
The aim of this study was to describe a variation of the breast reconstruction technique with myocutaneous flap of the fat-grafted latissimus dorsi muscle and its outcomes and evaluation of patient satisfaction.
This prospective cohort study included 18 patients and 19 reconstructed breasts, with 1 bilateral case. There were 7 cases of late reconstruction and 11 cases of immediate reconstruction. The flap was prepared with fat at the time of surgery, which was injected before its preparation. The evaluation of the results regarding shape, volume, and symmetry was performed through a satisfaction scale completed by patients and 2 physicians from 12 to 18 months after reconstruction.
On average, 171.31 mL of fat was injected (100-275 mL); the average time of unilateral surgery was 3 hours 42 minutes (3 hours to 4 hours 30 minutes). After a mean follow-up of 26.38 months (13-38 months), we did not observe complications of this new technique. In the evaluation performed by patients regarding the shape, volume, and symmetry, more than 80% rated the outcome as excellent and good, and the evaluations by the medical team were also satisfactory. In the comparative analysis between immediate and late reconstruction, patients who underwent immediate reconstruction were more satisfied.
This reconstruction technique with autologous fat injection was effective, with satisfactory and long-lasting results, and without the requirement for implants to set breast shape and volume.
本研究旨在描述一种采用脂肪移植背阔肌肌皮瓣进行乳房重建技术的变体及其效果，并评估患者满意度。
这项前瞻性队列研究纳入了18例患者和19个重建乳房，其中1例为双侧病例。有7例为延迟重建，11例为即刻重建。在手术时用脂肪制备皮瓣，在制备皮瓣前进行脂肪注射。在重建后12至18个月，通过患者和2名医生完成的满意度量表对形状、体积和对称性方面的结果进行评估。
平均注射脂肪171.31 mL（100 - 275 mL）；单侧手术平均时间为3小时42分钟（3小时至4小时30分钟）。平均随访26.38个月（13 - 38个月）后，我们未观察到这种新技术的并发症。在患者对形状、体积和对称性的评估中，超过80%将结果评为优秀和良好，医疗团队的评估也令人满意。在即刻重建和延迟重建的对比分析中，接受即刻重建的患者更满意。
这种自体脂肪注射重建技术是有效的，结果令人满意且持久，无需植入物来塑造乳房形状和体积。
