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Refined Method of Lipofilling following DIEP Breast Reconstruction: 3D Analysis of Graft Survival

BACKGROUND: The deep inferior epigastric perforator (DIEP) flap technique gives good clinical results, but aesthetic surgical adjustments are often necessary. Lipofilling represents a good complementary method, but fat resorption within the few months after surgery limits its use. Recently, a new pr...

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Autores principales: Nelissen, Xavier, Lhoest, Florence, Preud’Homme, Laurence
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wolters Kluwer Health 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4596451/
https://www.ncbi.nlm.nih.gov/pubmed/26495239
http://dx.doi.org/10.1097/GOX.0000000000000495
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author Nelissen, Xavier
Lhoest, Florence
Preud’Homme, Laurence
author_facet Nelissen, Xavier
Lhoest, Florence
Preud’Homme, Laurence
author_sort Nelissen, Xavier
collection PubMed
description BACKGROUND: The deep inferior epigastric perforator (DIEP) flap technique gives good clinical results, but aesthetic surgical adjustments are often necessary. Lipofilling represents a good complementary method, but fat resorption within the few months after surgery limits its use. Recently, a new protocol was introduced and successfully evaluated on murine models. This study aims to evaluate this protocol following a DIEP procedure by three-dimensional analysis. METHODS: Within a period of 4 months, every patient having undergone breast reconstruction with DIEP and who required a lipofilling adjustment was invited to take part in this study. All surgeries were performed using the Adip’sculpt disposable medical device MACROFILL (Laboratoires SEBBIN, Boissy-l’Aillerie, France). Fat resorption was analyzed using a three-dimensional photography system. RESULTS: Twenty-three patients were included, with a total of 25 breasts operated on. Injections were carried out on irradiated breasts in 73% of cases, and average injection volume was 124 mL (SD = 39 mL), whereas average operating time was 68 minutes (44–96 minutes). At an average follow-up of 5 months (4–8 months), 70.9% of projection gain afforded by the lipofilling was still present. CONCLUSIONS: It is now clear that particular rules should be respected for an efficient lipofilling, particularly regarding aspiration cannula characteristics, vacuum used, and the necessity of washes and soft centrifugations. We demonstrate here that by following a specific protocol that addresses these precautions, while using material that is specifically adapted, a 70.9% fat survival rate can be achieved, even in the very unfavorable case of postirradiation DIEP breast reconstruction.
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spelling pubmed-45964512015-10-22 Refined Method of Lipofilling following DIEP Breast Reconstruction: 3D Analysis of Graft Survival Nelissen, Xavier Lhoest, Florence Preud’Homme, Laurence Plast Reconstr Surg Glob Open Original Article BACKGROUND: The deep inferior epigastric perforator (DIEP) flap technique gives good clinical results, but aesthetic surgical adjustments are often necessary. Lipofilling represents a good complementary method, but fat resorption within the few months after surgery limits its use. Recently, a new protocol was introduced and successfully evaluated on murine models. This study aims to evaluate this protocol following a DIEP procedure by three-dimensional analysis. METHODS: Within a period of 4 months, every patient having undergone breast reconstruction with DIEP and who required a lipofilling adjustment was invited to take part in this study. All surgeries were performed using the Adip’sculpt disposable medical device MACROFILL (Laboratoires SEBBIN, Boissy-l’Aillerie, France). Fat resorption was analyzed using a three-dimensional photography system. RESULTS: Twenty-three patients were included, with a total of 25 breasts operated on. Injections were carried out on irradiated breasts in 73% of cases, and average injection volume was 124 mL (SD = 39 mL), whereas average operating time was 68 minutes (44–96 minutes). At an average follow-up of 5 months (4–8 months), 70.9% of projection gain afforded by the lipofilling was still present. CONCLUSIONS: It is now clear that particular rules should be respected for an efficient lipofilling, particularly regarding aspiration cannula characteristics, vacuum used, and the necessity of washes and soft centrifugations. We demonstrate here that by following a specific protocol that addresses these precautions, while using material that is specifically adapted, a 70.9% fat survival rate can be achieved, even in the very unfavorable case of postirradiation DIEP breast reconstruction. Wolters Kluwer Health 2015-09-25 /pmc/articles/PMC4596451/ /pubmed/26495239 http://dx.doi.org/10.1097/GOX.0000000000000495 Text en Copyright © 2015 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of The American Society of Plastic Surgeons. All rights reserved. This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND) (http://creativecommons.org/licenses/by-nc-nd/4.0/) , where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially.
spellingShingle Original Article
Nelissen, Xavier
Lhoest, Florence
Preud’Homme, Laurence
Refined Method of Lipofilling following DIEP Breast Reconstruction: 3D Analysis of Graft Survival
title Refined Method of Lipofilling following DIEP Breast Reconstruction: 3D Analysis of Graft Survival
title_full Refined Method of Lipofilling following DIEP Breast Reconstruction: 3D Analysis of Graft Survival
title_fullStr Refined Method of Lipofilling following DIEP Breast Reconstruction: 3D Analysis of Graft Survival
title_full_unstemmed Refined Method of Lipofilling following DIEP Breast Reconstruction: 3D Analysis of Graft Survival
title_short Refined Method of Lipofilling following DIEP Breast Reconstruction: 3D Analysis of Graft Survival
title_sort refined method of lipofilling following diep breast reconstruction: 3d analysis of graft survival
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4596451/
https://www.ncbi.nlm.nih.gov/pubmed/26495239
http://dx.doi.org/10.1097/GOX.0000000000000495
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