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Fat grafting in breast reconstructions with expanders and implants

ABSTRACT

Autologous fat grafting was first described more than 100 years ago by Neuber to correct facial defects. At the same time, Czerney described the use of a lipoma on the back to recreate a post-mastectomy breast. The technique was popularized by Coleman, who described the use of liposuction and adipocyte purification for injecting into the face as a soft tissue filling. Then, Bircoll and Novack (1987 apud Costantini et al.44 Costantini M, Cipriani A, Belli P, Bufi E, Fubelli R, Visconti G, et al. Radiological findings in mammary autologous fat injections: a multi-technique evaluation. Clin Radiol. 2013;68(1):27-33. DOI: https://doi.org/10.1016/j.crad.2012.05.009
https://doi.org/10.1016/j.crad.2012.05.0...
) extended this use to breasts. In 1990, there was a growth in the use of fat grafting after Coleman’s technique. This confirmed that adipose tissue could be satisfactorily transferred with the formalization of a restricted protocol for fat injection preparation. Coleman’s technique is by far the most commonly used. The adipose tissue is infiltrated with a tumescent solution and then manually aspirated. The liposuction material is subsequently centrifuged to isolate the adipose tissue from the oily and aqueous fraction and was then injected. Transferring fat from an excess area such as the abdomen or thighs to reconstruct or improve the shape and volume of the breast is not a new idea. Later, a study by Illouz on liposuction promoted the widespread use of the technique worldwide. Postoperative mammographic images to control fat absorption and necrosis vary. These can present as lipid cysts, suspected malignant findings such as grouped microcalcifications, spiculated areas of increased opacity, and focal masses.

Keywords:
Breast; Allografts; Breast implant; Tissue expansion devices; Review literature as a subject

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