自体脂肪移植在乳房整形中的应用  

Application of autologous fat grafting in mammaplasty

作　　者：陈园婧 尹博 柴一萌 李发成 Chen Yuanjing;Yin Bo;Chai Yimeng;Li Facheng(Department of Body Contouring and Fat Grafting Center,Plastic Surgery Hospital,Chinese Academy of Medical Sciences and Peking Union Medical College,Beijing 100144,China)

机构地区：[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

出　　处：《中华整形外科杂志》2021年第10期1086-1095,共10页Chinese Journal of Plastic Surgery

摘　　要：目的探讨自体脂肪移植用于乳房整形的临床效果。方法回顾性分析2010年12月至2020年12月于中国医学科学院整形外科医院形体雕塑与脂肪移植中心行自体脂肪移植乳房整形的病例资料。采用吸脂机低负压(-60 kPa)吸脂,生理盐水清洗后棉垫吸附法或轻柔离心法处理脂肪,以直径为2.5 mm的钝头注脂针于乳房受区行多层次注射。术后从常规乳腺检查和超声检查、第三方医师对患者手术前、后照片及患者对乳房满意度和生活质量的评分等方面评估手术效果,各项分数区间均为0~100分,评分越高表明效果越好。采用Mann-Whitney U检验比较放疗与未放疗组间差异,配对t检验比较手术前、后胸围差值及医师评分,P<0.05为差异有统计学意义。结果研究纳入449例女性共829侧乳房,患者年龄(37.6±9.4)岁,体质量指数(21.4±2.8)kg/m 2,其中乳房发育不良372例,乳腺癌全乳切除术后42例,乳腺癌保乳术后乳房畸形8例,假体隆乳术后27例。449例中有37例术前使用了Brava,包括25例乳房发育不良和12例乳腺癌全乳切除术后患者。所有患者均顺利完成手术,乳房发育不良患者行自体脂肪移植隆乳需要(2.0±0.7)次,单侧乳房每次移植量为(244.4±58.1)ml;乳腺癌全乳切除术后乳房再造需移植脂肪(2.9±1.1)次,单侧乳房每次移植量为(223.2±62.4)ml;乳腺癌保乳术后乳房畸形矫正需移植脂肪(1.5±0.5)次,单侧乳房每次移植量为(204.0±29.5)ml;假体隆乳术后患者假体取出后行自体脂肪移植隆乳需(2.2±0.8)次,单侧乳房每次移植量为(250.2±30.4)ml。术后随访(14.0±6.8)个月,34例患者乳腺超声发现直径0.1~0.3 cm的囊性结节及良性钙化,5例患者出现可触及结节,3例出现乳房内感染,无严重并发症发生。353例双侧乳房发育不良患者术后胸围较术前增加了(4.8±1.0)cm(P<0.01);27例双侧假体隆乳术后患者假体取出、自体脂肪移植隆乳后胸围较术前仅减�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/m2,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 deform

关 键 词：脂肪组织 自体移植物 乳房成形术 脂肪抽吸 脂肪移植术 

分 类 号：R655.8[医药卫生—外科学]