Muntean Maximilian Vlad, Pop Ioan Constantin, Ilies Radu Alexandru, Pelleter Annika, Vlad Ioan Catalin, Achimas-Cadariu Patriciu
Department of Plastic Surgery, "Prof. Dr. I. Chiricuță" Institute of Oncology, 400015 Cluj-Napoca, Romania.
Department of Plastic and Reconstructive Surgery, "Iuliu Hațieganu" University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania.
J Clin Med. 2025 Jun 9;14(12):4073. doi: 10.3390/jcm14124073.
: Hybrid breast reconstruction (HBR), combining implant-based breast reconstruction (IBR) with autologous fat grafting (FG), has emerged as a promising solution to improve aesthetic outcomes and reduce complications, especially in irradiated patients. This study aims to systematically review current evidence on the outcomes of HBR with a focus on complication rates and aesthetic satisfaction. : A systematic literature search was performed in March 2023 using PubMed and Embase databases. Studies were selected based on predefined PICOS criteria, including adult female patients undergoing IBR with FG. Sixteen studies met the inclusion criteria. Data on patient demographics, surgical techniques, fat grafting timing, complications, and aesthetic outcomes were extracted and analysed. : A total of 730 patients were included, with a mean follow-up of 20.23 months. The overall complication rate was 9%, with fat necrosis being the most common (2.7%). Capsular contracture occurred in 4.5% of cases. Immediate fat grafting during implant placement showed the lowest complication rate (8%) compared to delayed or staged procedures. Aesthetic satisfaction was high, with an average score of 4.4 out of 5 in five studies. Fat grafting improved skin quality and contour, especially in irradiated patients, and enabled the use of smaller implants. No oncological recurrences were reported. : HBR is associated with high aesthetic satisfaction and a low rate of complications. Immediate fat grafting during IBR appears to be the safest and most effective approach. These findings support the wider adoption of HBR, though further high-quality studies are needed to validate long-term safety and outcomes.
混合乳房重建（HBR），即将基于植入物的乳房重建（IBR）与自体脂肪移植（FG）相结合，已成为一种有前景的解决方案，可改善美学效果并减少并发症，尤其是在接受过放疗的患者中。本研究旨在系统回顾关于HBR结果的现有证据，重点关注并发症发生率和美学满意度。
2023年3月使用PubMed和Embase数据库进行了系统的文献检索。根据预先定义的PICOS标准选择研究，包括接受IBR联合FG的成年女性患者。16项研究符合纳入标准。提取并分析了患者人口统计学、手术技术、脂肪移植时机、并发症和美学结果的数据。
共纳入730例患者，平均随访20.23个月。总体并发症发生率为9%，脂肪坏死最为常见（2.7%）。4.5%的病例发生包膜挛缩。与延迟或分期手术相比，植入物放置期间立即进行脂肪移植的并发症发生率最低（8%）。美学满意度较高，五项研究中的平均评分为4.4（满分5分）。脂肪移植改善了皮肤质量和轮廓，尤其是在接受过放疗的患者中，并能够使用更小的植入物。未报告肿瘤复发情况。
HBR与高美学满意度和低并发症发生率相关。IBR期间立即进行脂肪移植似乎是最安全、最有效的方法。这些发现支持更广泛地采用HBR，不过需要进一步的高质量研究来验证长期安全性和结果。
