De Fazio Domenico, Cingozoglu Carlos Augusto Cutini
Plastic Surgery Division, Ospendale San Raffaele, Milan, Italy.
Private Practice, Bahía Blanca, Argentina.
Plast Reconstr Surg Glob Open. 2020 Feb 25;8(2):e1957. doi: 10.1097/GOX.0000000000001957. eCollection 2020 Feb.
The treatment of breast ptosis and gland hypoplasia in a single surgery is a challenging procedure and the result is less predictable. In this surgery, the complications mainly concern the prosthesis, such as implant deflation, capsular contracture, palpability, or malposition. We, therefore, propose a different and new technique that avoids breast prosthesis, combining mastopexy and autologous augmentation with fat grafts.
Combined mastopexy and autologous fat graft augmentation (lipopexy) was performed in women affected by breast ptosis and asymmetric breast or hypomastia. The breast lift technique was determined due to the ptosis level. The process of fat grafting was executed according to the PureGraft and, in some cases, to GID System, to Celution System or Carraway's techniques.
Thirty-four patients affected by breast ptosis and hypomastia underwent lipopexy from January 2010 to May 2017. The mean volume of adipose tissue injected for each breast was 225.98 ml. After surgery, the patients were followed for an average of 22.8 months. A mild ptosis relapse with partial fat absorption was observed in 4 cases (11.76%) and the presence of oily cysts was diagnosed in 2 patients (5.88%). One severe complication was recorded (hematoma drainage). All the patients healed uneventfully in 2 weeks.
This technique allows the surgeon to distribute the desired fat volume along the breasts, avoids implants, and displayed stable results. This treatment has been demonstrated not to interfere with follow-up breast imaging. We, therefore, consider lipopexy a valuable and safe alternative to mastopexy and mild to moderate breast volume augmentation.
在一次手术中治疗乳房下垂和腺体发育不全是一项具有挑战性的操作，结果较难预测。在这种手术中，并发症主要与假体有关，如植入物瘪陷、包膜挛缩、可触及性或位置异常。因此，我们提出一种不同的新技术，即避免使用乳房假体，将乳房上提术与自体脂肪移植隆乳术相结合。
对患有乳房下垂、乳房不对称或乳房发育不全的女性进行乳房上提术与自体脂肪移植隆乳术（脂肪注射隆乳术）联合手术。根据下垂程度确定乳房上提技术。脂肪移植过程按照PureGraft技术进行，在某些情况下，采用GID系统、Celution系统或卡拉韦技术。
2010年1月至2017年5月，34例患有乳房下垂和乳房发育不全的患者接受了脂肪注射隆乳术。每侧乳房注射的平均脂肪组织量为225.98毫升。术后，患者平均随访22.8个月。4例（11.76%）观察到轻度下垂复发伴部分脂肪吸收，2例（5.88%）诊断出存在油性囊肿。记录到1例严重并发症（血肿引流）。所有患者均在2周内顺利愈合。
该技术使外科医生能够在乳房上分布所需的脂肪量，避免使用植入物，并显示出稳定的效果。已证明这种治疗方法不会干扰后续的乳房影像学检查。因此，我们认为脂肪注射隆乳术是乳房上提术和轻至中度乳房增大术的一种有价值且安全的替代方法。
