From the Breast European Institute des Deux Rives, Strasbourg, France.
Ann Plast Surg. 2020 Oct;85(4):369-375. doi: 10.1097/SAP.0000000000002237.
The traditional extended latissimus dorsi flap technique, in addition to lipofilling, has been one of the main procedures used for breast reconstruction after mastectomy. However, to obtain excellent results, this technique requires a large muscle harvest and further lipofilling sessions. The lipofilled mini dorsi flap technique, performed in a single operation, appealed to us as a way to improve the traditional technique.We present our experience with the lipofilled mini dorsi flap technique in a new scenario.
We performed breast reconstruction with a lipofilled mini dorsi flap in female patients with breast cancer who underwent mastectomy and immediate breast reconstruction with a lipofilled mini dorsi flap. The operative technique is detailed in this article. The results were evaluated by the patients and the surgical team.
We performed 72 lipofilled mini dorsi flap procedures during breast reconstruction surgery from May 2017 to January 2019. Fifty-nine (81.9%) cases were immediate reconstructions. Complications, such as infection or necrosis of the flap, were not observed in this study. We noticed seroma and 1 case of infected lymphocele, which was drained.Body mass index (BMI) was directly related to postoperative dorsal seroma. The authors reported that greater BMI was associated with a higher seroma volume.Most patients evaluated their reconstruction as satisfactory. The surgical team evaluated most of the results as very satisfactory or satisfactory. There were no cases of unsatisfactory results reported either by the patients or the surgical team.
The lipofilled mini dorsi flap technique is an efficient, elegant, and less invasive solution that is more easily and quickly performed and achieves excellent long-term results in the immediate breast reconstruction scenario. For the first time to our knowledge, lipofilling was used to reduce the extent of latissimus dorsi dissection. The postoperative follow-up was better tolerated by patients. This technique may be offered to patients regardless of oncological treatment. In our experience, the lipofilled mini dorsi flap method has become the primary technique for immediate breast reconstruction.
传统的延长背阔肌皮瓣技术，除了脂肪填充外，一直是乳房切除术后乳房重建的主要方法之一。然而，为了获得出色的效果，该技术需要大量的肌肉采集和进一步的脂肪填充疗程。我们提出了在一种新的情况下使用脂肪填充迷你背阔肌皮瓣技术的经验。
我们对接受过乳房切除术和即刻乳房重建的乳腺癌女性患者进行了带脂肪填充的迷你背阔肌皮瓣乳房重建。本文详细介绍了手术技术。结果由患者和手术团队进行评估。
我们在 2017 年 5 月至 2019 年 1 月期间，在乳房重建手术中进行了 72 次带脂肪填充的迷你背阔肌皮瓣手术。59 例（81.9%）为即刻重建。在本研究中，未观察到皮瓣感染或坏死等并发症。我们注意到血清肿和 1 例感染性淋巴囊肿，均进行了引流。体重指数（BMI）与术后背部血清肿直接相关。作者报告说，BMI 越高，血清肿体积越大。大多数患者对重建效果表示满意。手术团队评估大多数结果为非常满意或满意。无论是患者还是手术团队都没有报告不满意的结果。
带脂肪填充的迷你背阔肌皮瓣技术是一种高效、优雅且微创的解决方案，在即刻乳房重建场景中，操作更简单、更快速，并能获得出色的长期效果。据我们所知，这是首次使用脂肪填充来减少背阔肌的解剖范围。患者更能耐受术后随访。无论患者接受何种肿瘤治疗，都可以向其提供该技术。在我们的经验中，带脂肪填充的迷你背阔肌皮瓣方法已成为即刻乳房重建的主要技术。
