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Autologous fat grafting has gained popularity in breast reconstruction surgery due to its natural appearance and palpation, its permanent effect, and its nutritional effect on scar tissue and irradiated areas.
However, the main challenge with fat grafting in breast reconstruction is the need for repeated sessions to achieve the desired volume, low maintenance doses when injecting large amounts of fat, and varying degrees of fat absorption
.
5 Skin tension is a major factor limiting injection volume and leading to fat absorption
tension
To further increase breast volume and provide a reliable breast shape, the flap can be advanced from the upper abdomen and lateral thorax to the breast
.
The aim of this study is to propose a breast reconstruction method that utilizes the principles of power-assisted liposuction and lipofilling (PALL) for breast matrix separation by infiltration, tunnelling, extensive destruction and fat augmentation, combined with ring (PALLL) Recruit a vascularized flap to reshape the breast
.
Figure 1 Source of the article
A prospective study was conducted from January 2014 to January 2019
.
Demographic data, surgical information (including volume of advancing flaps and lipofill recruited, and stage of lipofill), and complication data were collected .
statistics
Figure 2 Preoperative markings
.
(A) The midline, the anterior axillary line, the horizontal interaxillary line, and the inframammary fold are marked
Figure 3 Tunneling and depth
.
(A, B) Three-quarter cutaway view
Figure 4 Footprint loop
.
(A) Three-quarter profile view
Figure 5 IMF cycle
.
(A) Three-quarter profile view
Figure 6 Fat injection
.
Fat injected into the residual mammary stroma and crescent progresses in a multidirectional, multiplanar manner from the epigastric and lateral thoracic cavity
A total of 37 women (41 breasts) underwent PALLL breast reconstruction with a mean follow-up of 26 months
.
The mean age of the patients was 54 years, and the mean BMI was 29 kg/m 2
The mean recruited flap volume was 197 mL, and the mean fat filling volume was 153 mL for the first session, 190 mL for the second session, and 110 mL for the third session
.
9 patients required 3 treatments, 27 needed 2 treatments, and 1 patient needed only 1 treatment
.
Overall, 94% of patients were satisfied with the shape of their breasts
.
All patients reported breast sensitivity
.
Complications are rare
.
Breast reconstruction with PALLL is a minimally invasive alternative for reconstructing and reshaping the sensory breast, in which vascularized flaps recruited by the rings surrounding the breast are combined with fat grafting
.
Restoration of sensation is a major breakthrough compared to traditional breast reconstruction methods
.
This technique is an easy and safe option for reconstruction of small and medium breasts, even after radiation therapy
.
After training, the technology can be reimplemented and generalized
.
In conclusion, breast reconstruction using PALLL provides long-term shape stability with minimal scarring and low complication rates
.
original article
Abboud Marwan H,El Hajj Hiba,Kapila Ayush K et al.
Scarless Composite Breast Reconstruction Utilizing an Advancement Skin Flap, Loops, and Lipofilling.
[J] .
Aesthet Surg J, 2021, undefined: undefined.
