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胸前区混合式乳房重建：脂肪填充与乳房植入物的协同作用

The Prepectoral, Hybrid Breast Reconstruction: The Synergy of Lipofilling and Breast Implants.

作者信息

Stillaert Filip B J L, Lannau Bernd, Van Landuyt Koenraad, Blondeel Phillip N

机构信息

Department of Plastic and Reconstructive Surgery, University Hospital Ghent, Ghent, Belgium.

出版信息

Plast Reconstr Surg Glob Open. 2020 Jul 23;8(7):e2966. doi: 10.1097/GOX.0000000000002966. eCollection 2020 Jul.

DOI:10.1097/GOX.0000000000002966
PMID:32802660
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7413773/
Abstract

UNLABELLED

Breast reconstruction modalities are based on autologous tissue transfer, implants, or a combination of both. The aim of an allogeneic breast reconstruction is to minimize the impact of the implant on surrounding tissues to achieve an aesthetically pleasing result. Accurate tissue coverage, proper implant selection, and implant location are the absolute concerns in planning an implant-based reconstruction.

METHODS

A single surgeon's experience with the ergonomic, hybrid approach in primary and secondary breast reconstructions is presented. The hybrid approach is based on tissue expansion followed by serial sessions of fat grafting to augment the residual autologous (subcutaneous) compartment. The last step included the insertion of a prepectoral, ergonomic implant to obtain central core projection and additional volume.

RESULTS

Fifty-six hybrid breast reconstructions were performed with a mean follow-up of 24.1 months. Aesthetic outcomes and patient satisfaction have been good with pleasing breast projection, natural breast motion, and optimal coverage of the prepectoral implants.

CONCLUSIONS

The hybrid reconstructive approach is a reliable technique to improve the outcomes in implant-based breast reconstructions. The 2-step, prepectoral approach with expander-to-implant exchange allows better control of the final breast shape, and complications related to submuscular approaches are avoided. Fat grafting adds an autologous benefit to obtain natural results.

摘要

未标注

乳房重建方式基于自体组织转移、植入物或两者结合。同种异体乳房重建的目的是将植入物对周围组织的影响降至最低，以获得美观的效果。准确的组织覆盖、合适的植入物选择和植入物位置是基于植入物的重建规划中的绝对关注点。

方法

介绍了一位外科医生在一期和二期乳房重建中采用人体工程学混合方法的经验。混合方法基于组织扩张，随后进行一系列脂肪移植以增加残余自体（皮下）腔隙。最后一步包括插入胸前置入式人体工程学植入物以获得中央核心突出和额外体积。

结果

共进行了56例混合乳房重建，平均随访24.1个月。美学效果和患者满意度良好，乳房突出令人满意，乳房运动自然，胸前置入式植入物覆盖良好。

结论

混合重建方法是一种可靠的技术，可改善基于植入物的乳房重建效果。两步法胸前置入式方法，从扩张器到植入物的交换，可更好地控制最终乳房形状，避免了与胸肌下方法相关的并发症。脂肪移植增加了自体成分，以获得自然的效果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e196/7413773/49ea5207cade/gox-8-e2966-g008.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e196/7413773/8b76757b6bef/gox-8-e2966-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e196/7413773/4732a04404e1/gox-8-e2966-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e196/7413773/7d5fd2a33b79/gox-8-e2966-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e196/7413773/cedaa6bd92a6/gox-8-e2966-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e196/7413773/f327eaafd6db/gox-8-e2966-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e196/7413773/bfe936b4f373/gox-8-e2966-g006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e196/7413773/3d00774a0d91/gox-8-e2966-g007.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e196/7413773/49ea5207cade/gox-8-e2966-g008.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e196/7413773/8b76757b6bef/gox-8-e2966-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e196/7413773/4732a04404e1/gox-8-e2966-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e196/7413773/7d5fd2a33b79/gox-8-e2966-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e196/7413773/cedaa6bd92a6/gox-8-e2966-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e196/7413773/f327eaafd6db/gox-8-e2966-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e196/7413773/bfe936b4f373/gox-8-e2966-g006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e196/7413773/3d00774a0d91/gox-8-e2966-g007.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e196/7413773/49ea5207cade/gox-8-e2966-g008.jpg

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Implant Based Breast Reconstruction With Acellular Dermal Matrix: Safety Data From an Open-label, Multicenter, Randomized, Controlled Trial in the Setting of Breast Cancer Treatment.脱细胞真皮基质的乳房植入物重建：在乳腺癌治疗背景下的开放性、多中心、随机、对照试验的安全性数据。
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Current Approaches to Prepectoral Breast Reconstruction.
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