Application of autologous fat grafting in mammaplasty
10.3760/cma.j.cn114453-20210716-00307
- VernacularTitle:自体脂肪移植在乳房整形中的应用
- Author:
Yuanjing CHEN
1
;
Bo YIN
;
Yimeng CHAI
;
Facheng LI
Author Information
1. 中国医学科学院北京协和医学院整形外科医院形体雕塑与脂肪移植中心 100144
- Keywords:
Adipose tissue;
Autografts;
Mammaplasty;
Liposuction;
Fat grafting
- From:
Chinese Journal of Plastic Surgery
2021;37(10):1086-1095
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To assess the safety and efficacy of mammaplasty with autologous fat grafting(AFG).Methods:A retrospective analysis was conducted to review cases of mammaplasty with AFG from December 2010 to December 2020 in Department of Body Contouring and Fat Grafting Center, Plastic Surgery Hospital, Chinese Academy of Medical Sciences. Liposuction was performed using low negative pressure (-60 kPa) by liposuction machine. After lipoaspirate was washed with normal saline, cotton pad or low-speed centrifugation method was utilized to process fat. A blunt cannula with a diameter of 2.5 mm was used for multi-layer injection into the breast. The efficacy of surgery was evaluated from routine breast examinations, ultrasound examinations, third-party evaluations of pre- and post-operative photos, and patient’s scoring on breast appearance and the quality of life. The score interval is 0-100 points, and the higher the score, the better the effect. The Mann-Whitney U test was applied to compare the differences between groups, and the paired t-test was used to compare the difference of chest circumferences before and after surgery and the doctors’ scores. P<0.05 indicates statistically significant difference. Results:449 patients with 829 breasts were enrolled, aged (37.6±9.4) years old with a body mass index of (21.4±2.8) kg/m 2, including 372 patients with breast dysplasia, 42 patients underwent total mastectomy due to breast cancer, 8 patients with breast deformity after breast-conserving surgery, and 27 cases with breast implants for augmentation. Of the 449 cases, 37 cases used Brava before surgery, including 25 patients with breast dysplasia and 12 patients who underwent total mastectomy. All patients successfully completed the operation. Patients with breast dysplasia required (2.0±0.7) times of AFG for breast augmentation, with a unilateral injection volume of (244.4±58.1) ml per session. Patients who underwent total mastectomy required (2.9±1.1) times of AFG, with a unilateral injection volume of (223.2±62.4) ml per session. Patients with breast deformity after breast-conserving surgery required (1.5±0.5) times of AFG, with a unilateral injection volume of (204.0±29.5) ml per session. And for patients with breast implants for augmentation, it takes (2.2±0.8) times of AFG after removal of implants. The postoperative follow-up time was (14.0±6.8) months. Cystic nodules and benign calcifications with a diameter of 0.1-0.3 cm was found in 34 patients in ultrasound, 5 patients had palpable nodules and 3 patients had intramammary infections. No serious complications occurred. The breast circumference of 353 patients with bilateral breast dysplasia increased by (4.8±1.0) cm ( P<0.01) compared with that before operation. Breast circumference of the 27 patients who underwent implant removal and AFG for augmentation reduced by (1.2±1.7) cm ( P<0.01) after operation. The scores of third-party after operation in each group were significantly higher than those before operation ( P<0.05). The doctor’s score of patients with breast reconstruction after total mastectomy for breast cancer increased the most, which was 15.4±4.9 points ( P<0.01). In this group, the scores of patients who underwent radiotherapy increased by (19.3±2.3) points, which was higher than those without radiotherapy 13.4±5.5 points ( P<0.01). Patients with breast reconstruction after total mastectomy for breast cancer had the lowest breast satisfaction and quality of life scores, which were 84.6±2.9 and 84.7±3.2 points respectively, while those with breast deformity correction after breast conserving surgery had the highest scores, 88.8±4.0 and 90.6±3.7 points respectively. Conclusions:The application of AFG to mammaplasty is both safe and effective, with fewer complications, and high satisfaction rate.
