TY - JOUR
T1 - Composite Breast Remodeling after Implant Removal by Tissue Recruitment and Loops Fixation with Power-Assisted Liposuction and Lipofilling (PALLL)
AU - Abboud, Marwan H.
AU - Kapila, Ayush K.
AU - Bogaert, Svetlana
AU - Abboud, Nicolas M.
N1 - Publisher Copyright:
© 2021 The Aesthetic Society. Reprints and permission: [email protected].
PY - 2021/7/1
Y1 - 2021/7/1
N2 - Background: An increasing number of women wish breast implant removal whilst maintaining an acceptable projection and form were possible. Objectives: The authors propose a technique to remodel the breast after implant removal utilizing internal suture loops to project the breast, recruit abdominal and axillary tissue cranially and medially, and provide a matrix for lipofilling. Methods: A prospective analysis was performed of consecutive patients undergoing implant extraction followed by power-assisted liposuction loops and lipofilling. Patient characteristics were measured. The aesthetic results were evaluated by 2 independent raters. Patient-reported satisfaction was measured by standardized questionnaires. Results: Implants in 52 patients with an average age of 55 and body mass index of 23.7 were extracted followed by breast remodeling. A total of 73% of patients had implants for aesthetic reasons, 41% were smokers, and 43% of the reconstruction cases received radiotherapy. A total of 28% had implant extraction for rupture, 58% for capsular contracture, and 14% due to pain and migration. The average volume of the implants removed was 292 cc, followed by an average lipofilling of 223 cc, yielding a ratio of 0.76 to 1. The average tissue recruited by loops was 82.5 cc. Independent raters measured 79% of results as good, 13% as acceptable, and 8% as requiring improvement; 80% of patients were satisfied to very satisfied. Conclusions: The authors propose implant extraction followed by power-assisted liposuction loops and lipofilling can provide footprint definition, sustained projection, and high patient satisfaction. Moreover, the recruitment of a vascularized adipo-cutaneous flap by loops allows a reduced ratio of fat grafting to implant volume.
AB - Background: An increasing number of women wish breast implant removal whilst maintaining an acceptable projection and form were possible. Objectives: The authors propose a technique to remodel the breast after implant removal utilizing internal suture loops to project the breast, recruit abdominal and axillary tissue cranially and medially, and provide a matrix for lipofilling. Methods: A prospective analysis was performed of consecutive patients undergoing implant extraction followed by power-assisted liposuction loops and lipofilling. Patient characteristics were measured. The aesthetic results were evaluated by 2 independent raters. Patient-reported satisfaction was measured by standardized questionnaires. Results: Implants in 52 patients with an average age of 55 and body mass index of 23.7 were extracted followed by breast remodeling. A total of 73% of patients had implants for aesthetic reasons, 41% were smokers, and 43% of the reconstruction cases received radiotherapy. A total of 28% had implant extraction for rupture, 58% for capsular contracture, and 14% due to pain and migration. The average volume of the implants removed was 292 cc, followed by an average lipofilling of 223 cc, yielding a ratio of 0.76 to 1. The average tissue recruited by loops was 82.5 cc. Independent raters measured 79% of results as good, 13% as acceptable, and 8% as requiring improvement; 80% of patients were satisfied to very satisfied. Conclusions: The authors propose implant extraction followed by power-assisted liposuction loops and lipofilling can provide footprint definition, sustained projection, and high patient satisfaction. Moreover, the recruitment of a vascularized adipo-cutaneous flap by loops allows a reduced ratio of fat grafting to implant volume.
UR - http://www.scopus.com/inward/record.url?scp=85108303418&partnerID=8YFLogxK
U2 - 10.1093/asj/sjaa327
DO - 10.1093/asj/sjaa327
M3 - Review article
C2 - 33647099
AN - SCOPUS:85108303418
SN - 1090-820X
VL - 41
SP - 770
EP - 782
JO - Aesthetic Surgery Journal
JF - Aesthetic Surgery Journal
IS - 7
ER -