Breast Reconstruction and Augmentation Using Pre-Expansion and Autologous Fat Transplantation

Khouri, Roger K.; Vecchio, Daniel Del

doi:10.1016/j.cps.2008.11.009

Cited by 157 publications

(64 citation statements)

References 13 publications

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“…Autologous fat grafting (AFG) has been widely used in plastic surgery and has allowed reconstruction of different types of tissue defects [1][2][3][4][5][6][7][8][9][10][11][12] . According to the International Society of Aesthetic Plastic Surgery, in 2009, AFG represented almost 6 percent of the nonsurgical aesthetic procedures, with more than 500,000 procedures performed globally 15,16 .…”

Section: ■ Discussionmentioning

confidence: 99%

“…In breast reconstruction field, AFG play an important part in the surgical treatment and rehabilitation [4][5][6] . The main benefits are related to low donor-site morbidity, operative time and more natural aesthetic results.…”

Section: ■ Discussionmentioning

confidence: 99%

“…This aspect is due to a reduced graft-torecipient interface, which results to apoptosis and AFG necrosis 4,9,14 .…”

Section: ■ Introductionmentioning

confidence: 99%

“…Despite AFG technique was first introduced by Neuber in 1893 13 , only more recently some authors have described technique details, expanding its availability and making it as a constant topic in many centers worldwide [1][2][3][4][5][6][7][8][9][10][11][12] . However, AFG is not a standard technique and clinical series demonstrate a variability of surgical procedures and results 5,11,14,15 .…”

Section: ■ Introductionmentioning

confidence: 99%

“…Autologous fat grafting (AFG) has been widely used in aesthetic and reconstructive surgery [1][2][3][4][5][6][7][8][9] . The possibility to transfer significant volume of fat has greatly improved the restoration of tissue defects following oncological diseased, congenital birth defects or major traumas [7][8][9][10] .…”

Section: ■ Introductionmentioning

confidence: 99%

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Qualitative analysis of the viability of autogenous fat grafts grafted in different environments of interstitial pressure. Preliminary results and description of a new experimental model in mini-pigs

Arruda

Munhoz²,

Matsumoto

et al. 2017

Acta Cir. Bras.

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Purpose: To evaluate the feasibility of an experimental model of autologous fat graft (AFG) in different interstitial pressure (IP) environments. Methods: Three mini-pigs(Minipig-BR) with age of 8 months (weight: 25-30 kg) were used. AFG were collected from the bucal fat pad, and grafted in the intramuscular pocket (biceps femoralis muscle). IP model was based on a fusiform ressection followed by primary closure "under tension". A blood pressure catheter located in the intramuscular region connected to a pressure module was applied to quantify IP. Results: The mean operative time was 236 min (210 -272 min). All the AFG and muscular segments were removed successfully. Average interstitial pressure CP and H were 3 and 10.6 mmHg respectively. The AFG were biopsied for histopathological analysis 30 days after graft. Hematoxylin-eosin staining and immunohistochemical analyzes (TNF-alpha, CD31 and Perilipine with monoclonal antibodies) were employed. Conclusion: The data show that minipigs model could be used as a recipient site for autologous fat graft techniques and allow the development of studies to explore the AFG intake and pathophysiology response.

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Section: ■ Discussionmentioning

confidence: 99%

Section: ■ Discussionmentioning

confidence: 99%

“…This aspect is due to a reduced graft-torecipient interface, which results to apoptosis and AFG necrosis 4,9,14 .…”

Section: ■ Introductionmentioning

confidence: 99%

Section: ■ Introductionmentioning

confidence: 99%

Section: ■ Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Qualitative analysis of the viability of autogenous fat grafts grafted in different environments of interstitial pressure. Preliminary results and description of a new experimental model in mini-pigs

Arruda

Munhoz²,

Matsumoto

et al. 2017

Acta Cir. Bras.

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Effect of Total Breast Reconstruction With Autologous Fat Transfer Using an Expansion Device vs Implants on Quality of Life Among Patients With Breast Cancer

et al. 2023

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ImportanceThere is a need for a new, less invasive breast reconstruction option for patients who undergo mastectomy in their breast cancer treatment.ObjectiveTo investigate quality of life (QoL) among patients undergoing a new breast reconstruction technique, autologous fat transfer (AFT), compared with that among patients undergoing implant-based reconstruction (IBR).Design, Setting, and ParticipantsThe BREAST trial was a randomized clinical trial conducted between November 2, 2015, and October 31, 2021, performed in 7 hospitals across the Netherlands. Follow-up was 12 months. Referrals could be obtained from general practitioners and all departments from participating or nonparticipating hospitals. The patients with breast cancer who had undergone mastectomy and were seeking breast reconstruction were screened for eligibility (radiotherapy history and physique) by participating plastic surgeons. Patients receiving postmastectomy radiotherapy were excluded.InterventionsBreast reconstruction with AFT plus expansion or 2-phased IBR. Randomization was done in a 1:1 ratio.Main Outcomes and MeasuresThe statistical analysis was performed per protocol. The predefined primary outcome was QoL at 12 months after final surgery. This was measured by the BREAST-Q questionnaire, a validated breast reconstruction surgery questionnaire. Questions on the BREAST-Q questionnaire are scored from 0 to 100, with a higher score indicating greater satisfaction or better QoL (depending on the scale). Secondary outcomes were breast volume and the safety and efficacy of the techniques.ResultsA total of 193 female patients (mean [SD] age, 49.2 [10.6] years) 18 years or older who desired breast reconstruction were included, of whom 91 patients in the AFT group (mean [SD] age, 49.3 [10.3] years) and 80 in the IBR group (mean age, 49.1 [11.0] years) received the allocated intervention. In total, 64 women in the AFT group and 68 women in the IBR group completed follow-up. In the IBR group, 18 patients dropped out mainly due to their aversion to implant use while in the AFT group 6 patients ended their treatment prematurely because of the burden (that is, the treatment being too heavy or tiring). The BREAST-Q scores were higher in the AFT group in all 5 domains and significantly higher in 3: satisfaction with breasts (difference, 9.9; P = .002), physical well-being: chest (difference; 7.6; P = .007), and satisfaction with outcome (difference, 7.6; P = .04). Linear mixed-effects regression analysis showed that QoL change over time was dependent on the treatment group in favor of AFT. The mean (SD) breast volume achieved differed between the groups (AFT: 300.3 [111.4] mL; IBR: 384.1 [86.6] mL). No differences in oncological serious adverse events were found.Conclusions and RelevanceThis randomized clinical trial found higher QoL and an increase in QoL scores over time in the AFT group compared with the IBR group. No evidence was found that AFT was unsafe. This is encouraging news since it provides a third, less invasive reconstruction option for patients with breast cancer.Trial RegistrationClinicalTrials.gov Identifier: NCT02339779

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Breast reconstruction using autologous fat

Khonji

2010

British Journal of Surgery

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Breast Reconstruction and Augmentation Using Pre-Expansion and Autologous Fat Transplantation

Cited by 157 publications

References 13 publications

Qualitative analysis of the viability of autogenous fat grafts grafted in different environments of interstitial pressure. Preliminary results and description of a new experimental model in mini-pigs

Qualitative analysis of the viability of autogenous fat grafts grafted in different environments of interstitial pressure. Preliminary results and description of a new experimental model in mini-pigs

Effect of Total Breast Reconstruction With Autologous Fat Transfer Using an Expansion Device vs Implants on Quality of Life Among Patients With Breast Cancer

Breast reconstruction using autologous fat

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