Elisabeth Russe1, Hassan Kholosy2, Laurenz Weitgasser3, Michael Brandstetter3, Heike Traintinger4, Jennifer Neureiter5, Gottfried Wechselberger5, Thomas Schoeller3. 1. Department of Plastic and Reconstructive Surgery, Hospital of the Barmherzige Brüder, Teaching Hospital of the Paracelsus Medical University Salzburg, Salzburg, Austria. Electronic address: lisa@russe.at. 2. Department of Plastic and Reconstructive Surgery, Hospital of the Barmherzige Brüder, Teaching Hospital of the Paracelsus Medical University Salzburg, Salzburg, Austria; Department of Plastic Surgery, Faculty of Medicine, Alexandria University, 1 Champlion Street, 21131 Alexandria, Egypt. 3. Department of Hand-, Breast-, and Reconstructive Microsurgery, Marienhospital Stuttgart, Böheimstraβe 37, 70199 Stuttgart, Stuttgart, Germany. 4. Department of Plastic and Reconstructive Surgery, Hospital of the Barmherzige Brüder, Teaching Hospital of the Paracelsus Medical University Salzburg, Salzburg, Austria; Department of Hand-, Breast-, and Reconstructive Microsurgery, Marienhospital Stuttgart, Böheimstraβe 37, 70199 Stuttgart, Stuttgart, Germany. 5. Department of Plastic and Reconstructive Surgery, Hospital of the Barmherzige Brüder, Teaching Hospital of the Paracelsus Medical University Salzburg, Salzburg, Austria.
Abstract
BACKGROUND: The transverse myocutaneous gracilis (TMG) flap is a viable option for the reconstruction of small- to moderate-sized breasts. The purpose of this series was to examine the outcomes of fat grafting to breast and donor site secondary to breast reconstruction with a TMG flap. METHODS: A cohort study was conducted to identify all patients who underwent autologous fat grafting after breast reconstruction with a TMG flap at two institutions between January 2009 and October 2013. Data were collected regarding patient demographics, body mass index, and medical history as well as surgical details regarding TMG flap surgery and fat grafting. RESULTS: A total of 145 fat graftings were performed in 83 patients following TMG flap breast reconstruction to improve the contour, shape, and volume of breasts (98%, n = 142), donor site (9%, n = 13) or both (7%, n = 10), mainly after breast cancer surgery (83%). On average, 1.8 fat grafting sessions were performed with an average of 30cc fat per breast and 56.4cc fat per thigh. In 72% of patients, fat injection was performed by other pending reconstructive procedures. Fat was harvested by the tumescent technique, by using a filter syringe system, and injected without any further processing in multiple layers. CONCLUSIONS: Autologous fat grafting as a secondary procedure represents a powerful adjunct to enhance the aesthetic outcome of the reconstructed breast and donor site. It can be easily combined with other pending reconstructive procedures. With additional fat grafting, it may be possible to expand indications and offer autologous reconstruction with a TMG flap even in very lean patients.
BACKGROUND: The transverse myocutaneous gracilis (TMG) flap is a viable option for the reconstruction of small- to moderate-sized breasts. The purpose of this series was to examine the outcomes of fat grafting to breast and donor site secondary to breast reconstruction with a TMG flap. METHODS: A cohort study was conducted to identify all patients who underwent autologous fat grafting after breast reconstruction with a TMG flap at two institutions between January 2009 and October 2013. Data were collected regarding patient demographics, body mass index, and medical history as well as surgical details regarding TMG flap surgery and fat grafting. RESULTS: A total of 145 fat graftings were performed in 83 patients following TMG flap breast reconstruction to improve the contour, shape, and volume of breasts (98%, n = 142), donor site (9%, n = 13) or both (7%, n = 10), mainly after breast cancer surgery (83%). On average, 1.8 fat grafting sessions were performed with an average of 30cc fat per breast and 56.4cc fat per thigh. In 72% of patients, fat injection was performed by other pending reconstructive procedures. Fat was harvested by the tumescent technique, by using a filter syringe system, and injected without any further processing in multiple layers. CONCLUSIONS: Autologous fat grafting as a secondary procedure represents a powerful adjunct to enhance the aesthetic outcome of the reconstructed breast and donor site. It can be easily combined with other pending reconstructive procedures. With additional fat grafting, it may be possible to expand indications and offer autologous reconstruction with a TMG flap even in very lean patients.
Authors: Sara Taha; Elias Volkmer; Elisabeth Haas; Paolo Alberton; Tobias Straub; Diana David-Rus; Attila Aszodi; Riccardo Giunta; Maximilian Michael Saller Journal: Int J Mol Sci Date: 2020-02-06 Impact factor: 5.923
Authors: Laura C Siegwart; Sebastian Fischer; Yannick F Diehm; Jörg M Heil; Christoph Hirche; Ulrich Kneser; Dimitra Kotsougiani-Fischer Journal: Breast Cancer Date: 2021-06-06 Impact factor: 4.239