Innesti adiposi autologhi nella chirurgia ricostruttiva della mammella: tecnica chirurgica

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BACKGROUND: Autologous fat grafting can be considered an ideal filler to correct breast contour deformities, scars and loss of volume. The major advantage was the presence of virtually limitless donor tissue that was soft and malleable. Moreover, autologous fat is rich on adipose tissue-derived stem cells (ADSCs) that can be differentiate in various cell types and have also a lot of biological property like secretion of trophic factors, low immunogenicity and immunesuppression, which make them an important resource for many clinical applications. METHODS: We performed a conventional liposuction using a centrifuge with a closed-circuit pump system. The aspiration was carried out with appropriate 50-mL disposable syringes, FPU (Fat Processing Unit calls), which have inside a particular piston containing a filter from 50-100 microns and a metallic weight, which function to exert a greater pressure on the adipose tissue during the centrifugation process. After infiltration with Klein solution with a 2.5×260-mm cannula, we proceed to the liposuction of adipose tissue with a 4×260-mm tube, without the need to change the tools. Finally, the syringes containing the fat collected were centrifuged at 3000 rpm for 3 minutes. After that, the layer of intact, viable and concentrate adipocytes were injected into areas of interest with a 4×170-mm cannula. RESULTS: 80% of patients considered themselves satisfied with the result after the first intervention of lipofilling and saw no need to undergo further treatment. In 15% of cases, a second surgery to achieve a functional and aesthetic effect more than acceptable for the patients it was necessary to run. In a small percentage of cases (5%), we were practiced three interventions of lipofilling before being able to achieve the desired improvement. CONCLUSIONS: The proposed surgical technique gives perfect filling results and definition, high-satisfaction on the part of patients after the first intervention by lipofilling.

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