Skin trophicity improvement by mechanotherapy for lipofilling‐based breast reconstruction postradiation therapy

Razzouk, Kaïs; Humbert, Philippe; Borens, Bruno; Gozzi, Marie; Khori, Noor Al; Pasquier, Jennifer; Tabrizi, Arash Rafii

doi:10.1111/tbj.13645

Cited by 8 publications

(6 citation statements)

References 16 publications

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“…Initially, 292 articles were screened by title and abstract. However, only 48 articles were assessed for full-text eligibility, and among those, 12 studies were eventually included [14][15][16][17][18][19][20][21][22][23][24]. Of the 36 articles excluded after full-text reading, the majority were rejected due to a lack of clear extractable data on hybrid breast reconstruction and mentioned complications.…”

Section: Resultsmentioning

confidence: 99%

Outcomes in Hybrid Breast Reconstruction: A Systematic Review

et al. 2022

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Background and Objectives: Lipofilling is a commonly performed procedure worldwide for breast augmentation and correction of breast contour deformities. In breast reconstruction, fat grafting has been used as a single reconstructive technique, as well as in combination with other procedures. The aim of the present study is to systematically review available studies in the literature describing the combination of implant-based breast reconstruction and fat grafting, focusing on safety, complications rate, surgical sessions needed to reach a satisfying reconstruction, and patient-reported outcomes. Materials and Methods: We adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) throughout the whole review protocol. A systematic review of the literature up to April 2022 was performed using Medline, Embase, and Cochrane Library databases. Only studies dealing with implant-based breast reconstruction combined with fat grafting were included. Results: We screened 292 articles by title and abstract. Only 48 articles were assessed for full-text eligibility, and among those, 12 studies were eventually selected. We included a total of 753 breast reconstructions in 585 patients undergoing mastectomy or demolitive breast surgeries other than mastectomy (quadrantectomy, segmentectomy, or lumpectomy) due to breast cancer or genetic predisposition to breast cancer. Overall, the number of complications was 60 (7.9%). The mean volume of fat grafting per breast per session ranged from 59 to 313 mL. The mean number of lipofilling sessions per breast ranged from 1.3 to 3.2. Conclusions: Hybrid breast reconstruction shows similar short-term complications to standard implant-based reconstruction but with the potential to significantly decrease the risk of long-term complications. Moreover, patient satisfaction was achieved with a reasonably low number of lipofilling sessions (1.7 on average).

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Section: Resultsmentioning

confidence: 99%

Outcomes in Hybrid Breast Reconstruction: A Systematic Review

et al. 2022

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“…The skin and subcutaneous tissue of the thoracic wall should be prepared before mastectomy using a soft skin aspiration. For this, we used Dr Khouri's BRAVA system and then the CELLU M6 Alliance LPG system 25–28 . It requires 30-minute suction sessions under the control of a physiotherapist, twice a week, for 1 month before fat grafting.…”

Section: Discussionmentioning

confidence: 99%

“…For this, we used Dr Khouri's BRAVA system and then the CELLU M6 Alliance LPG system. [25][26][27][28] It requires 30-minute suction sessions under the control of a physiotherapist, twice a week, for 1 month before fat grafting. Both methods resulted in similar skin preparation.…”

Section: Discussionmentioning

confidence: 99%

“…The thoracic wall skin of the receiving site was prepared 15 days before the second and consecutive fat transfers using at first the Dr Khouri's BRAVA system (Brava LLC, Miami, Fla) and since 2016 the CELLU M6 Alliance LPG system (Technoarc de la Plaine, Valence, France). [25][26][27][28] The transfers were done through 1 or 2 small holes in the external or internal lower (under the inframammary fold) breast poles and one in the external upper pole (axillary extension of the breast). Multiple rigotomies were necessary to get a better shape and a high projection of the reconstructed breast.…”

Section: Autologous Fat Transfer Injection Proceduresmentioning

confidence: 99%

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Autologous Fat Grafting as a Stand-alone Method for Immediate Breast Reconstruction After Radical Mastectomy in a Series of 15 Patients

et al. 2021

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Objective: To date, breast reconstruction after mastectomy essentially uses flapor prosthetic-based surgery. Autologous fat grafting (AFT) largely used in breast conservative surgery is considered an additional technique in breast reconstruction. The aim of this retrospective study was to report our experience of AFT as a stand-alone method for immediate breast reconstruction. Patients and Methods: Fifteen patients requiring a radical mastectomy underwent AFT for immediate reconstruction since 2014. Previous breast irradiation was not a contraindication. Procedures, complications, and cosmetic results were retrospectively analyzed. Results: Fifteen patients with an average age of 60.5 (43-78) years were included in this retrospective study. They had a body mass index ranging from 19 to 40. Fourteen had a mastectomy for cancer and 1 for prophylaxis. Nine received breast irradiation (7 before surgery and 2 adjuvant). A mean of 3 (2-6) AFT procedures were required to achieve total breast reconstruction. Except for the first transfer, others were performed as outpatient surgeries. Only 2 minor complications (1 hematoma and 1 abscess) not impairing results were reported. The results after a mean follow-up of 26 months were considered by the patients and surgeon as highly satisfactory even in previously irradiated breast, as assessed using a qualitative scoring analysis. Conclusions: Autologous fat grafting as a stand-alone method for immediate breast reconstruction after radical mastectomy is a safe procedure with very consistent results even for patients requiring radiation therapy.

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“…About ten sessions are needed to improve local trophicity, which facilitates fat transfer and the suppleness of the skin and deep tissues. 13 Fat transfer is performed with a cannula of 1.5 to 2mm in diameter, with a single lateral hole at its tip and measuring 13 to 25cm depending on the areas to be treated. This cannula is used to deposit "filaments" or "spaghetti" of fat in different planes of the breast.…”

Section: Surgical Techniques Fat Collectionmentioning

confidence: 99%

Enhancing Breast Reconstruction: An Analysis of 117 Patients Undergoing Delayed Autologous Fat Grafting

Fitoussi,

Razzouk,

Raei

2023

Arch Breast Cancer

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Background: The number of total mastectomy patients requesting breast reconstruction is increasing. However, many patients refuse this surgery because the procedures are too complex, too prone to complications, or even just because of the fear of breast implants and their long-term consequences. In this study, a comprehensive assessment of the results and complications of only fat grafting breast reconstruction is presented. Methods: Between 2012 and 2021, 127 fat grafting breast reconstruction was performed in 117 patients who previously received total mastectomy. These included 70 cases of delayed breast reconstruction (DBR) and 57 "conversions," i.e., removal of a reconstructive implant replaced by iterative fat injections. The patients were fully informed about the procedure's risks and benefits before intervention. All the patients signed an informed consent. The procedure, complications, and results were analyzed on a regular basis every 3-6 months (average follow-up of 3 years). Results: Data from 117 patients with a mean age of 59 years (25-83) were included in this study. The mean body mass index was 23 (19-30). Seventy patients had received radiotherapy before mastectomy (55%). An average of 3.17 injections (2 to 7) with an average volume of 300 cc were required to finalize the breast reconstruction, with a total average injected volume of 933 cc. Simple fat transfers were performed on an outpatient basis except for bilateral or associated procedures. In 48 cases (40%), the patients received appropriate procedures on the contralateral breast to make it symmetrical. Complications happened in 10 percent of cases, mostly minor complications like fatty cysts or much-localized Cytosteatonecrosis though in a limited number of patients, more serious problems with hematomas, abscesses, diffuse Cytosteatonecrosis or very extensive lymphoceles appeared. Conclusion: The findings of this study support fat transfer breast reconstruction as a safe procedure with acceptably low complications, even in patients who have received radiotherapy in their history. Furthermore, this procedure can be applied in an outpatient setting. It seems that the application and the indications of this easy and feasible procedure will be increased in the coming years.

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Skin trophicity improvement by mechanotherapy for lipofilling‐based breast reconstruction postradiation therapy

Abstract: Breast J. 2020;26:725-728. wileyonlinelibrary.com/journal/tbj | 725

Cited by 8 publications

References 16 publications

Outcomes in Hybrid Breast Reconstruction: A Systematic Review

Outcomes in Hybrid Breast Reconstruction: A Systematic Review

Autologous Fat Grafting as a Stand-alone Method for Immediate Breast Reconstruction After Radical Mastectomy in a Series of 15 Patients

Enhancing Breast Reconstruction: An Analysis of 117 Patients Undergoing Delayed Autologous Fat Grafting

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