scholarly journals Treatment of an abscess after massive autologous fat transplantation for breast augmentation with real-time ultrasonography-guided liposuction

2019 ◽  
Vol 25 (4) ◽  
pp. 154-158
Author(s):  
Seo Gil Choi ◽  
Junekyu Kim
Author(s):  
Giuseppe Cuccia ◽  
Carola Maria Gagliardo ◽  
Marco Romeo ◽  
Benedetto Di Trapani

Abstract Background Autologous fat transplantation for breast augmentation represents an increasingly interesting technique in plastic surgery. Only a few standardized procedures are available. Hybrid augmentation mastopexy combines the benefits of autologous fat transplantation and implant-based breast augmentation mastopexy, reducing implant-related complications and prothesis size. Herein, we describe our surgical approach as a “hybrid aesthetic surgery.” Methods A retrospective analysis of all patients who underwent hybrid breast augmentation and lifting with simultaneous fat grafting was carried out. Clinical outcomes, ultrasound evaluation of upper pole fullness, aesthetic postoperative results, and complications were examined. Results Eighteen patients with a mean age of 33 years (range: 24–52 years) and mean BMI of 25.8 kg/m2 (range: 21.4–32.1 kg/m2) were included in this study. Mean injected fat volume per breast was 115 cc (range: 78–144 cc). Patients were followed up for a mean of 9.4 months (range: 6–24 months). No fat necrosis or major complications were encountered during the follow-up. Patient satisfaction was high in terms of breast shape, size, and coverage of the breast implant. No recurrence of ptosis was observed yet and no secondary revision surgery was performed. Conclusions Hybrid mastopexy augmentation is an effective and safe procedure that combines the benefits of autologous fat grafting and implant-based breast augmentation. The transfer of autologous soft tissue allows obtaining a natural breast shape, reducing the onset of rippling and prothesis size. The reduction of prothesis size prevents ptosis recurrence but provides the desired projection. This reliable option improves long-term breast shape with elevated patient’s satisfaction. Level of evidence: Level IV, therapeutic study.


Author(s):  
Fang-Wei Li ◽  
Li Zeng ◽  
Sheng-Kang Luo

Abstract Background Autologous fat is currently one of the most commonly used soft tissue materials in plastic surgery, but the changes that occur in fat after transplantation are unclear. Existing studies on the changes in surviving fat mostly involve animal experiments. Objectives The aim of this study was to obtain surviving fat 1 year after clinical autologous fat transplantation for breast augmentation, to explain the microenvironmental changes after fat transplantation from a clinical perspective, and to verify previous research conclusions, thus providing new insight into fat survival. Methods Samples of surviving fat were obtained from 5 patients 1 year after they had undergone autologous fat transplantation for breast augmentation, and normal fat samples were obtained from 5 patients who had not undergone this procedure. The differences between CD68 and CD31 were analyzed immunohistochemically, and between CD34 and Ki67 by immunofluorescence. We also tested whether UCP-1 is expressed in surviving fat. Results The relative CD68, CD34, and Ki67 expression levels in the surviving fat tissue were significantly higher than those in the normal fat tissue (PCD68 = 0.04, PCD34 = 0.03, PKi67 = 0.02). The relative CD31 expression was not significantly different between the two groups (P = 0.52). No UCP-1 expression was observed in any surviving fat tissue. Conclusions Chronic inflammatory reactions mediated by macrophages were detectable 1 year after autologous fat transplantation for breast augmentation. The mesenchymal stem cell content in surviving fat was higher than that in normal fat, but the number of blood vessels was close to that in normal breast fat tissue. No genesis of brown fat was found. Level of Evidence: 5


Author(s):  
Yingjie Wu ◽  
Feng Hu ◽  
Xueping Li ◽  
Guoqian Yin

Abstract Background Autologous fat transfer (AFT) has already become a part of clinical practice for aesthetic breast augmentation, even though evidence regarding its efficacy is still lacking. Objectives To determine the current worldwide status and efficacy, techniques, and oncologic safety on this subject. Methods PubMed, EMBASE, and Cochrane Library databases were searched to identify all relevant studies. Results Eighty-four articles published between 1987 and April 2020, consisting of 6468 patients, were included, and 64 studies consisting of 5162 unique patients were included in the meta-analysis. Most studies had a low level of evidence (levels 2b–5); In this meta-analysis, there were 17 prospective cohort studies, four retrospective cohort studies, six case-control studies, and 38 case series. The publications were from 21 countries. Indications for autologous fat transplantation were aesthetic augmentation (93.2%) and congenital malformation (6.8%). Among the 5162 patients, two cases (0.04%) of cancer were reported. The meta-analysis revealed very high overall patient and surgeon satisfaction rates of 93% and 87%, respectively. Overall, only 1.56 sessions were needed to achieve the desired result. Long-term survival was calculated to be about 60–70% at 1-year follow-up. Only 8% of procedures resulted in clinical complications, and 5% of patients required biopsy because of abnormal clinical or radiological findings. Conclusions Autologous fat transplantation seems to be a major tool in aesthetic breast augmentation. Preoperative patient selection is essential but under-reported. Future research should focus on evaluating the technical and patient factors influencing the rate of fat survival and its oncological safety.


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