Breast Augmentation with Autologous Fat Grafting Immediately after Removal of Polyacrylamide Hydrogel and Fibrotic Capsule in 162 Patients

Abstract

Objective In this study we investigated the feasibility and efficacy of immediate breast augmentation with autologous fat grafting after removal of polyacrylamide hydrogel(PAAG) and fibrotic capsule. Methods A retrospective study was conducted on 162 female patients who underwent removal of breast filler polyacrylamide hydrogel(PAAG) and the fibrotic capsule which produced after injection of PAAG via areola Omega-shaped incision. Then autologous fat grafting was immediately performed evenly and radially around the areola via the same incision into different layers (subcutaneous,submammary tissue,pectoralis major intramuscular and inferior pectoralis major space) except the empty cavity.The cavity left by removal of PAAG and fibrous capsule was closed with negative pressure drainage tube and slight external pressure. Results All patients recovered well without severe complications. The average score of postoperative satisfaction with physical well-being:chest was 99.83 (total score:100) compared with the average satisfaction score of 71.69 (total score:100) preoperatively by means of BREAST-QTM evaluation(P<0.01).All patients were satisfied with their postoperative breast shape. Conclusions Removing as much as possible is critical for patients who underwent the PAAG injection.Our experience in immediate breast augmentation with autologous fat grafting after removal of PAAG and fibrotic capsule proved useful and effective to maintain the balance between removing the PAAG as much as possible and retaining soft tissue to reshape breasts.

Autologous fat grafting in breast augmentation: A systematic review highlighting the need for clinical caution

“…[6][7][8][9][10][11][12][13][14][16][17][18] The included studies' characteristics are shown in Table 1. There were 15 prospective studies, 8,[10][11][12][13][14]18,[22][23][24]28,30,31,35,39 17 retrospective studies, 6,7,9,16,17,20,21,[25][26][27][32][33][34][35][36][37]40 and three randomized controlled trials. 29,38,41,43 A total of 3757 women were included, and the mean age was 40.5 years (range, 17 to 78 years).…”

“…Following full-text screening, 58 articles were excluded for study design, interventions, and/or outcomes not of interest, and 35 articles were included. 6–14,16–18,20–42 The included studies’ characteristics are shown in Table 1. There were 15 prospective studies, 8,10–14,18,22–24,28,30,31,35,39 17 retrospective studies, 6,7,9,16,17,20,21,25–27,32–37,40 and three randomized controlled trials.…”

“…Six studies 20,22,25,30,35,42 ( n = 510) recorded patient satisfaction after AFG over a 1-year follow-up period with an average of 92% satisfaction (range, 83.2% to 97.5%). Seven studies used questionnaires to assess patient satisfaction, 22,25,26,30,33,42 with four using the BREAST-Q questionnaire for this purpose, 26,30,35,42 one 35 combining the BREAST Q with the Likert five-point scale, and another 20 assessing the satisfaction of patients preoperatively and postoperatively using a combined Likert scale; two studies developed other questionnaires to assess patient satisfaction. 22,25…”

“…The Coleman technique or a modification of it was used in 19 studies. 6,7,[9][10][11]13,17,21,22,26,31,[33][34][35][36]42,43 Five studies reported the use of the Brava 11,12,14,27,43 system preoperatively and postoperatively, and two studies (n = 230) used grafts enriched with PRP. 9,40 Plastic and Reconstructive Surgery • March 2024 530e…”

“…Six studies 20,22,25,30,35,42 (n= 510) recorded patient satisfaction after AFG over a 1-year followup period with an average of 92% satisfaction (range, 83.2% to 97.5%). Seven studies used questionnaires to assess patient satisfaction, 22,25,26,30,33,42 with four using the BREAST-Q questionnaire for this purpose, 26,30,35,42…”