Hartiala Pauliina, Steiner Aida K, Niemi Tarja
From the Department of Plastic and General Surgery, Turku University Hospital, Turku, Finland.
Medicity Research Laboratories, InFLAMES Research Flagship, University of Turku, Turku, Finland.
Plast Reconstr Surg Glob Open. 2025 Jan 10;13(1):e6447. doi: 10.1097/GOX.0000000000006447. eCollection 2025 Jan.
Liposuction is a common procedure for patients with lymphedema with nonpitting adipose tissue hypertrophy. However, routinely, the lipoaspirate is discarded. Experimental studies have shown that adipose-derived stem cells in fat may enhance the regenerative and lymphangiogenic effects of the fat. Recent evidence has shown that lymphedema fat is enriched in adipose-derived stem cell populations, thus making it an interesting regenerative option. This article introduces a novel surgical technique using the lipoaspirate of a patient with lymphedema for regenerative purposes. A 42-year-old woman developed lymphedema 18 months after mastectomy and axillary lymph node dissection surgery. The patient underwent upper limb liposuction and latissimus dorsi flap reconstruction of the breast. Lipofilling of the flap and axillary area after scar release was performed using suctioned lymphedema fat. The results showed a sustained reduction in the volume of the lymphedema arm, an improved lymphatic transport index, decreased fluid extravasation, and new lymphatics in the upper arm. At 64-month follow-up, the patient had good breast symmetry, had minimal swelling of the lymphedema arm, and rarely used compression garments. This report is the first to use lymphedema fat for regenerative purposes, differentiating it from existing literature that uses healthy fat. In conclusion, successful dual-effect fat grafting with lymphedema fat presents a promising avenue for further investigation. This innovative approach addresses breast cancer-related lymphedema and offers potential benefits in regenerative and lymphangiogenic effects without the need for microsurgical expertise. This case report emphasizes the importance of exploring this novel option for future research and clinical applications.
抽脂术是治疗伴有非凹陷性脂肪组织肥大的淋巴水肿患者的常用方法。然而，通常情况下，抽脂吸出物会被丢弃。实验研究表明，脂肪中的脂肪源性干细胞可能会增强脂肪的再生和淋巴管生成作用。最近的证据表明，淋巴水肿脂肪中富含脂肪源性干细胞群体，因此使其成为一个有趣的再生选择。本文介绍了一种新颖的外科技术，即利用淋巴水肿患者的抽脂吸出物用于再生目的。一名42岁女性在乳房切除和腋窝淋巴结清扫手术后18个月出现淋巴水肿。该患者接受了上肢抽脂术和背阔肌皮瓣乳房重建术。在瘢痕松解后，使用抽吸得到的淋巴水肿脂肪对皮瓣和腋窝区域进行脂肪填充。结果显示，淋巴水肿手臂的体积持续减小，淋巴运输指数提高，液体外渗减少，上臂出现了新的淋巴管。在64个月的随访中，患者乳房对称性良好，淋巴水肿手臂肿胀最小，很少使用加压服装。本报告首次将淋巴水肿脂肪用于再生目的，与使用健康脂肪的现有文献有所不同。总之，成功地将淋巴水肿脂肪进行双效脂肪移植为进一步研究提供了一个有前景的途径。这种创新方法解决了与乳腺癌相关的淋巴水肿问题，并在无需显微外科专业知识的情况下，在再生和淋巴管生成作用方面提供了潜在益处。本病例报告强调了探索这一新颖选择用于未来研究和临床应用的重要性。
