Abboud Marwan H, El Hajj Hiba, Kapila Ayush K, Bogaert Svetlana, Abboud Nicolas M
Plastic and Reconstructive Surgery Department, Centre Hospitalier Universitaire de Tivoli, La Louvière, Belgium.
Department of Plastic and Reconstructive Surgery at the University Hospital Brussels (UZ Brussel) in Jette, Belgium.
Aesthet Surg J. 2022 Jan 1;42(1):38-53. doi: 10.1093/asj/sjab049.
Autologous fat grafting has gained popularity in breast reconstructive surgery. To further increase the breast volume and provide a reliable breast shape, a skin flap can be advanced from the upper abdomen and lateral thorax to the breast.
The aim of this study was to propose a method of breast reconstruction utilizing the principles of power-assisted liposuction and lipofilling (PALL) for breast matrix dissociation applied through infiltration, tunnelization, extensive undermining and lipofilling, in combination with loops (PALLL) to recruit a vascularized flap to reshape the breast.
A prospective study was performed from January 2014 to January 2019. Demographic data, surgical procedure information (including volumes of the recruited advancement flap and lipofilling, and stages of lipofilling), and complication data were collected. Patient-reported outcomes, including satisfaction and well-being, were measured by a questionnaire.
In total, 37 women (41 breasts) underwent breast reconstruction by PALLL with an average follow-up of 26 months. The mean age of the patients was 54 years, and their mean BMI was 29 kg/m2. The mean recruited flap volume was 197 mL, and the mean lipofilling volumes were 153 mL for the first session, 190 mL for the second session, and 110 mL for the third session. Nine patients needed 3 sessions, 27 patients 2 sessions, and 1 patient only 1 session. Overall, 94% of patients were satisfied with their breast shape. All patients reported sensitive breasts. There were minimal complications.
Breast reconstruction with PALLL is a minimally invasive alternative to reconstructing and reshaping sensate breasts in which a vascularized skin flap recruited by loops from breast surroundings is combined with fat grafting. This approach provides long-term shape stability with minimal scarring and low complication rates.
自体脂肪移植在乳房重建手术中越来越受欢迎。为了进一步增加乳房体积并提供可靠的乳房形状，可以将皮瓣从上腹部和侧胸推进到乳房。
本研究的目的是提出一种乳房重建方法，该方法利用动力辅助吸脂和脂肪填充（PALL）的原理，通过浸润、隧道化、广泛剥离和脂肪填充来进行乳房基质解离，并结合皮瓣环（PALLL）来募集带血管化皮瓣以重塑乳房。
2014年1月至2019年1月进行了一项前瞻性研究。收集了人口统计学数据、手术过程信息（包括募集的推进皮瓣体积和脂肪填充量以及脂肪填充阶段）和并发症数据。通过问卷调查来衡量患者报告的结果，包括满意度和幸福感。
共有37名女性（41个乳房）接受了PALLL乳房重建，平均随访26个月。患者的平均年龄为54岁，平均体重指数为29kg/m²。募集的皮瓣平均体积为197mL，第一次脂肪填充的平均体积为153mL，第二次为190mL，第三次为110mL。9名患者需要进行3次填充，27名患者进行2次填充，1名患者仅进行1次填充。总体而言，94%的患者对乳房形状满意。所有患者均报告乳房有感觉。并发症极少。
PALLL乳房重建是一种微创的替代方法，用于重建和重塑有感觉的乳房，其中通过皮瓣环从乳房周围募集的带血管化皮瓣与脂肪移植相结合。这种方法提供了长期的形状稳定性，疤痕最小且并发症发生率低。
