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Large Viable Fat Nodules, Months Post-Transfer, inside Radiated Breast Implant Pocket: A Case Report
The cell survival theory and the cell replacement theory contribute to the current thinking regarding free adipose graft persistence after transplantation and influence the principles applied to autologous fat transfer procedures. Both theories necessitate the reestablishment of circulation for graf...
Autores principales: | , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Wolters Kluwer Health
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7253257/ https://www.ncbi.nlm.nih.gov/pubmed/32537369 http://dx.doi.org/10.1097/GOX.0000000000002722 |
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author | Hagarty, Sarah E. Santos, Edward F. Luo, Jessica |
author_facet | Hagarty, Sarah E. Santos, Edward F. Luo, Jessica |
author_sort | Hagarty, Sarah E. |
collection | PubMed |
description | The cell survival theory and the cell replacement theory contribute to the current thinking regarding free adipose graft persistence after transplantation and influence the principles applied to autologous fat transfer procedures. Both theories necessitate the reestablishment of circulation for graft survival. To minimize ischemic death, according to Khouri, fat grafts should be injected with at most 1.6-mm-wide ribbons to optimize the graft-to-recipient interface for oxygen diffusion and neovascularization. The graft is eventually incorporated into the surrounding tissue. We present a curious intraoperative finding, in a 51-year-old woman 2.5 months post-grafting for failed implant reconstruction after radiation. Several large, well-circumscribed, clearly viable adipose tissue nodules, up to 2 cm in diameter, were present inside the capsule. These were so loosely attached to the capsule of the breast pocket that a mere gentle hand sweep and irrigation after opening the cavity caused them to dislodge and float to the surface of the irrigation fluid. This finding begs additional questions about the current understanding of the mechanisms of tissue viability after grafting. It raises the clinical possibility that larger aliquots of transferred fat can be viable than previously perceived. |
format | Online Article Text |
id | pubmed-7253257 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | Wolters Kluwer Health |
record_format | MEDLINE/PubMed |
spelling | pubmed-72532572020-06-11 Large Viable Fat Nodules, Months Post-Transfer, inside Radiated Breast Implant Pocket: A Case Report Hagarty, Sarah E. Santos, Edward F. Luo, Jessica Plast Reconstr Surg Glob Open Case Report The cell survival theory and the cell replacement theory contribute to the current thinking regarding free adipose graft persistence after transplantation and influence the principles applied to autologous fat transfer procedures. Both theories necessitate the reestablishment of circulation for graft survival. To minimize ischemic death, according to Khouri, fat grafts should be injected with at most 1.6-mm-wide ribbons to optimize the graft-to-recipient interface for oxygen diffusion and neovascularization. The graft is eventually incorporated into the surrounding tissue. We present a curious intraoperative finding, in a 51-year-old woman 2.5 months post-grafting for failed implant reconstruction after radiation. Several large, well-circumscribed, clearly viable adipose tissue nodules, up to 2 cm in diameter, were present inside the capsule. These were so loosely attached to the capsule of the breast pocket that a mere gentle hand sweep and irrigation after opening the cavity caused them to dislodge and float to the surface of the irrigation fluid. This finding begs additional questions about the current understanding of the mechanisms of tissue viability after grafting. It raises the clinical possibility that larger aliquots of transferred fat can be viable than previously perceived. Wolters Kluwer Health 2020-03-25 /pmc/articles/PMC7253257/ /pubmed/32537369 http://dx.doi.org/10.1097/GOX.0000000000002722 Text en Copyright © 2020 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of The American Society of Plastic Surgeons. 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 without permission from the journal. |
spellingShingle | Case Report Hagarty, Sarah E. Santos, Edward F. Luo, Jessica Large Viable Fat Nodules, Months Post-Transfer, inside Radiated Breast Implant Pocket: A Case Report |
title | Large Viable Fat Nodules, Months Post-Transfer, inside Radiated Breast Implant Pocket: A Case Report |
title_full | Large Viable Fat Nodules, Months Post-Transfer, inside Radiated Breast Implant Pocket: A Case Report |
title_fullStr | Large Viable Fat Nodules, Months Post-Transfer, inside Radiated Breast Implant Pocket: A Case Report |
title_full_unstemmed | Large Viable Fat Nodules, Months Post-Transfer, inside Radiated Breast Implant Pocket: A Case Report |
title_short | Large Viable Fat Nodules, Months Post-Transfer, inside Radiated Breast Implant Pocket: A Case Report |
title_sort | large viable fat nodules, months post-transfer, inside radiated breast implant pocket: a case report |
topic | Case Report |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7253257/ https://www.ncbi.nlm.nih.gov/pubmed/32537369 http://dx.doi.org/10.1097/GOX.0000000000002722 |
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