Troell Robert J
Private Practice, Department of Surgery, Touro University Nevada, Las Vegas, NV 89148, USA.
J Clin Med. 2025 Aug 8;14(16):5607. doi: 10.3390/jcm14165607.
: Variability and low volume yield in breast aesthetic outcomes utilizing fat grafting promoted a search for surgical technique improvement. : Using evidence-based information to optimize a surgical technique for aesthetic breast augmentation using stem cell-enriched fat grafting. : Retrospective study of consecutive women (n = 118) from 2008 to 2025 requesting breast fat grafting using centrifugation-filtration fat processing combined with platelet-rich plasma and autologous adipose-derived stem cell-enriched fat. : Most surgical indications were for primary breast augmentation (65.8%), followed by fat grafting after implant removal (13.6%), during or after mammoplasty (13.6%), or simultaneously with implant exchange (12.7%). The mean volume per breast of purified, enriched fat grafted was 192 to 206 cc. Each patient had fat grafted into the subcutaneous plane with some patients having additional fat placed submuscularly in those without a dual plane or submuscularly placed implant, or where an implant capsule was absent. Most patients were either very satisfied or satisfied (95.8%), with 4.2% dissatisfied. Those dissatisfied were mainly those with insufficient breast volume and one with a suspected atypical mycobacteria infection. There was a 11.9% complication rate, with seroma formation at the harvested site the most common at 5.1% (n = 6). Palpable fibrotic areas were second in frequency at 3.4% (n = 4), but with no instances of breast oil cyst formation. The average number of fat grafting sessions per indication was only one, with 6.8% requesting a second staged fat grafting procedure. The revision procedures were only in patients with a sole augmentation indication, except for one mastopexy patient with severe breast size asymmetry. An estimated 75-85% grafted volume take was confirmed by a previous diagnostic ultrasound measurement study. : Breast fat grafting incorporating learned knowledge of optimal harvesting, processing, storing, enrichment, and administration techniques yielded superior consistent breast enhancement aesthetic outcomes with a high patient and surgeon satisfaction rate through increased adipocyte survival, while minimizing complications including a low incidence of fibrotic areas and no oil cyst formation.
利用脂肪移植进行乳房美学手术时，其结果存在变异性且产量低，这促使人们寻求手术技术的改进。利用循证信息优化使用富含干细胞的脂肪移植进行美学隆乳的手术技术。对2008年至2025年期间连续118名要求进行乳房脂肪移植的女性进行回顾性研究，采用离心过滤脂肪处理技术，结合富含血小板血浆和富含自体脂肪来源干细胞的脂肪。大多数手术指征为原发性隆乳（65.8%），其次是取出植入物后的脂肪移植（13.6%）、乳房成形术期间或之后（13.6%）或与更换植入物同时进行（12.7%）。每侧乳房移植的纯化、富集脂肪平均体积为192至206立方厘米。每位患者的脂肪都移植到皮下平面，一些患者在没有双平面或植入物位于肌下或没有植入物包膜的情况下，额外的脂肪放置在肌下。大多数患者非常满意或满意（95.8%），4.2%不满意。那些不满意的主要是乳房体积不足的患者以及一名疑似非典型分枝杆菌感染的患者。并发症发生率为11.9%，采集部位血清肿形成最为常见，为5.1%（n = 6）。可触及的纤维化区域发生率次之，为3.4%（n = 4），但没有出现乳腺油囊肿形成的情况。每个指征的脂肪移植平均次数仅为一次，6.8%的患者要求进行二期脂肪移植手术。修复手术仅针对单纯隆乳指征的患者，除了一名乳房大小严重不对称的乳房上提术患者。通过先前的诊断性超声测量研究证实，估计有75 - 85%的移植脂肪存活。结合最佳采集、处理、储存、富集和给药技术的乳房脂肪移植，通过提高脂肪细胞存活率，产生了卓越且一致的乳房美学改善效果，患者和外科医生满意度高，同时将并发症降至最低，包括纤维化区域发生率低且无油囊肿形成。
