TY - JOUR
T1 - Scarless Composite Breast Reconstruction Utilizing an Advancement Skin Flap, Loops, and Lipofilling
AU - Abboud, Marwan H.
AU - El Hajj, Hiba
AU - Kapila, Ayush K.
AU - Bogaert, Svetlana
AU - Abboud, Nicolas M.
N1 - Publisher Copyright:
© 2021 The Aesthetic Society. Reprints and permission: [email protected].
PY - 2022/1/1
Y1 - 2022/1/1
N2 - Background: Autologous fat grafting has gained popularity in breast reconstructive surgery. To further increase the breast volume and provide a reliable breast shape, a skin flap can be advanced from the upper abdomen and lateral thorax to the breast. Objectives: The aim of this study was to propose a method of breast reconstruction utilizing the principles of power-assisted liposuction and lipofilling (PALL) for breast matrix dissociation applied through infiltration, tunnelization, extensive undermining and lipofilling, in combination with loops (PALLL) to recruit a vascularized flap to reshape the breast. Methods: A prospective study was performed from January 2014 to January 2019. Demographic data, surgical procedure information (including volumes of the recruited advancement flap and lipofilling, and stages of lipofilling), and complication data were collected. Patient-reported outcomes, including satisfaction and well-being, were measured by a questionnaire. Results: In total, 37 women (41 breasts) underwent breast reconstruction by PALLL with an average follow-up of 26 months. The mean age of the patients was 54 years, and their mean BMI was 29 kg/m2. The mean recruited flap volume was 197 mL, and the mean lipofilling volumes were 153 mL for the first session, 190 mL for the second session, and 110 mL for the third session. Nine patients needed 3 sessions, 27 patients 2 sessions, and 1 patient only 1 session. Overall, 94% of patients were satisfied with their breast shape. All patients reported sensitive breasts. There were minimal complications. Conclusions: Breast reconstruction with PALLL is a minimally invasive alternative to reconstructing and reshaping sensate breasts in which a vascularized skin flap recruited by loops from breast surroundings is combined with fat grafting. This approach provides long-term shape stability with minimal scarring and low complication rates.
AB - Background: Autologous fat grafting has gained popularity in breast reconstructive surgery. To further increase the breast volume and provide a reliable breast shape, a skin flap can be advanced from the upper abdomen and lateral thorax to the breast. Objectives: The aim of this study was to propose a method of breast reconstruction utilizing the principles of power-assisted liposuction and lipofilling (PALL) for breast matrix dissociation applied through infiltration, tunnelization, extensive undermining and lipofilling, in combination with loops (PALLL) to recruit a vascularized flap to reshape the breast. Methods: A prospective study was performed from January 2014 to January 2019. Demographic data, surgical procedure information (including volumes of the recruited advancement flap and lipofilling, and stages of lipofilling), and complication data were collected. Patient-reported outcomes, including satisfaction and well-being, were measured by a questionnaire. Results: In total, 37 women (41 breasts) underwent breast reconstruction by PALLL with an average follow-up of 26 months. The mean age of the patients was 54 years, and their mean BMI was 29 kg/m2. The mean recruited flap volume was 197 mL, and the mean lipofilling volumes were 153 mL for the first session, 190 mL for the second session, and 110 mL for the third session. Nine patients needed 3 sessions, 27 patients 2 sessions, and 1 patient only 1 session. Overall, 94% of patients were satisfied with their breast shape. All patients reported sensitive breasts. There were minimal complications. Conclusions: Breast reconstruction with PALLL is a minimally invasive alternative to reconstructing and reshaping sensate breasts in which a vascularized skin flap recruited by loops from breast surroundings is combined with fat grafting. This approach provides long-term shape stability with minimal scarring and low complication rates.
UR - http://www.scopus.com/inward/record.url?scp=85122771658&partnerID=8YFLogxK
U2 - 10.1093/asj/sjab049
DO - 10.1093/asj/sjab049
M3 - Article
C2 - 33507232
AN - SCOPUS:85122771658
SN - 1090-820X
VL - 42
SP - 38
EP - 53
JO - Aesthetic Surgery Journal
JF - Aesthetic Surgery Journal
IS - 1
ER -