Hybrid Breast Augmentation: A Reliable Formula for Preoperative Assessment of Fat Graft Volume Based on Implant Volume and Projection

Abstract

Background Autogenous fat grafting (AFG) is an established technique used as an adjunct to breast augmentation (BA) to redesign breast shape. Surgeons often use experience and intuition to estimate AFG volume, which can result in incorrect assessment of donor areas and unnecessary fat removal. Objectives This aim of this study was to develop a method based on a mathematical formula, which utilizes implant volume and projection to predict AFG volume. Methods Thirty patients (60 breasts) underwent primary hybrid BA. A software package (SketchUp) was used to simulate 3-dimensional AFG and implant volumes, which in turn were used to develop an equation for estimating AFG volume according to 3 different implant projections. The results for each group were compared, via Pearson’s correlation coefficient, with the results of the clinical series. Results All patients received Motiva Ergonomix SmoothSilk/SilkSurface implants, ranging in volume from 175 to 355 cc (mean, 265 cc), as well as an average AFG volume of 79.2 cc/breast (range, 50-110 cc). Twenty-nine patients (96.6%) were either very satisfied or satisfied during a mean follow-up of 18 months (range, 6-28 months). A high correlation was observed between the AFG performed in the cohort and predictions obtained from the formula (r = 0.938, P < 0.001). Conclusions The AFG volume in hybrid BA procedures can be estimated utilizing measurements based on implant volume/projection. This low-cost method can be applied to guide surgical decision-making in patients who are candidates for BA. Level of Evidence: 4

Zones for Fat Grafting in Hybrid Breast Augmentation: Standardization for Planning of Fat Grafting Based on Breast Cleavage Units

“…12,18,28 In cases where pinch test results exceed 3 to 4 cm, from our point of view autologous fat grafting is unnecessary, and instead subfascial breast augmentation is indicated. 18,28 In secondary breast augmentation, the main indications are soft-tissue deficiency and the presence of previous visible implant contours or rippling. 30,31 Some studies have described specific areas for performing autologous fat grafting.…”

“…To evaluate the applicability of the formula proposed herein in predicting autologous fat graft volumes for zones I/II and III (in line with a previous standardization 18 ), we compared (Above) Zone I, in contact with the implant pocket, and zone II, in the upper portion and in contact with the subclavicular area. Zone III is defined as extending from the medial marking of the implant pocket to 1 cm from the midsternal line.…”

“…To evaluate the applicability of the formula proposed herein in predicting autologous fat graft volumes for zones I/II and III (in line with a previous standardization 18 ), we compared the estimated results calculated by the formula with the real autologous fat graft volumes in a cohort of 30 patients (60 breasts) who underwent hybrid breast augmentation with the two surgeons (A.M.M. and J.M.M.)…”

A Preliminary Exploratory Study of Autologous Fat Transplantation in Breast Augmentation With Different Fat Transplantation Planes

“…Fat grafting is increasingly used for cosmetic breast augmentation (4). Currently, fat graft retention is more predictable and ideal using standardized techniques (5)(6)(7), but complications that occur after breast augmentation with fat grafting have made it controversial for wider use and further study is required (8).…”

Multiple polyurethane implant punctures during fat grafting: case report and review of the literature

“…), adding volume, changing the form and avoiding submuscular implant placement [3][4][5][6][7][8][9][10][11][12][13]. Simultaneous combination of BA with implants and FG is called hybrid or composite BA [6,11,12,14,15]. FG to the breast with implants inside carries the risk of the implant puncture.…”