Fat grafting in autologous breast reconstruction:applications,outcomes,safety,and complications  

作　　者：Bahaa Shaaban David Guerrero Carolyn De La Cruz Lauren Kokai 

机构地区：[1]Department of Plastic Surgery,University of Pittsburgh,Pittsburgh,PA 15213,USA [2]University of Pittsburgh Medical Center,Pittsburgh,PA 15213,USA [3]Department of Bioengineering,University of Pittsburgh,Pittsburgh,PA 15213,USA [4]McGowan Institute for Regenerative Medicine,Pittsburgh,PA 15213,USA

出　　处：《Plastic and Aesthetic Research》2023年第1期485-500,共16页整形与美容研究（英文版）

摘　　要：Autologous fat grafting is an important surgical technique in aesthetic and reconstructive procedures.Fat grafting for breast reconstruction is now an established procedure for adding volume and improving cutaneous pliability;it can be used independently to replace more invasive flap procedures or implants,or as an adjunct for smaller volume supplementation.The breadth of applications in the breast necessitates diversity in technique and approach,and while there is no universally agreed-upon protocol,basic principles have guided the evolution of some commonly adopted tenets.Broadly,fat grafting outcomes are highly favorable but dependent on patient and procedure factors,requiring learned patient selection and expertise in recipient site assessment.Common complications from fat grafting,such as fat necrosis and the development of nodules,are particularly troublesome for post-oncologic patients,requiring considerable pre-surgical consultation for patient education and managing expectations.In addition to volume and contour augmentation,fat grafting has additional beneficial effects that have recently drawn increased attention including pain reduction from implant capsular contracture or postmastectomy pain syndrome,improved skin quality and reduced fibrosis following radiation,and possible anti-tumorigenic effects.New developments in clinical fat grafting research that are promising include the use of adipose progenitor cells admixed with lipoaspirate for improved volume retention or alternative biologics such as platelet-rich plasma.Preclinically,research towards safe and effective regenerative medicine approaches is actively underway,with the ultimate goal of achieving predictable and increased graft retention,reducing the number of required surgical procedures and enabling on-table results to reflect procedure outcomes.

关 键 词：Fat grafting fat transfer autologous breast reconstruction implant reconstruction lipo-injection breast augmentation graft survival skin expansion MASTECTOMY post-mastectomy pain breast fibrosis capsular contracture 

分 类 号：R73[医药卫生—肿瘤]