Patricia Gutierrez-Ontalvilla1, Nina S Naidu2,3, Eva Lopez Blanco1, Eloy Condiño Brito4, Alejandro Ruiz-Valls4. 1. Department of Plastic and Reconstructive Surgery, Functional Unit of Plastic Pediatric, La Fe University Hospital, Valencia, Spain. 2. , New York, USA. drnaidu@naiduplasticsurgery.com. 3. Weill Cornell Medical Center, New York, NY, 10065, USA. drnaidu@naiduplasticsurgery.com. 4. Department of Plastic and Reconstructive Surgery, La Fe University Hospital, Valencia, Spain.
Abstract
BACKGROUND: Tuberous breast deformity in the adolescent can be a source of anxiety and social isolation. Current techniques of implant placement and flap reconstruction are not always feasible in this population. OBJECTIVES: The authors evaluated the use of autologous fat grafting with percutaneous fasciotomy and reduction in the nipple-areolar complex for correction of tuberous breast deformity in teenagers. METHODS: A retrospective chart review was conducted for nine teenaged patients with tuberous breast deformity who received autologous fat grafting between January 2016 and December 2018. The recipient site was prepared with the use of percutaneous fasciotomies to release the constricted lower pole of the breast, lowering of the inframammary crease, and reduction in the nipple-areolar complex. Fat was harvested by conventional liposuction prior to injection through three designated sites located at the inframammary fold, anterior axillary line, and upper pole. Complications were recorded. RESULTS: Patients had an average age of 14.9 years at the time of surgery. An average of 1.8 filling sessions were required with a mean of 220 cc of fat injected per breast. Patients were followed for an average of 21 months postoperatively. No serious complications were noted. All patients reported satisfaction with their final outcomes. CONCLUSIONS: Autologous fat grafting in conjunction with percutaneous fasciotomy and reduction in the nipple-areolar complex is a safe and effective treatment of the tuberous breast deformity in teenage patients. It provides an esthetic result with minimal scarring and high satisfaction rates while eliminating the need for flaps or implants. LEVEL OF EVIDENCE IV: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.
BACKGROUND:Tuberous breast deformity in the adolescent can be a source of anxiety and social isolation. Current techniques of implant placement and flap reconstruction are not always feasible in this population. OBJECTIVES: The authors evaluated the use of autologous fat grafting with percutaneous fasciotomy and reduction in the nipple-areolar complex for correction of tuberous breast deformity in teenagers. METHODS: A retrospective chart review was conducted for nine teenaged patients with tuberous breast deformity who received autologous fat grafting between January 2016 and December 2018. The recipient site was prepared with the use of percutaneous fasciotomies to release the constricted lower pole of the breast, lowering of the inframammary crease, and reduction in the nipple-areolar complex. Fat was harvested by conventional liposuction prior to injection through three designated sites located at the inframammary fold, anterior axillary line, and upper pole. Complications were recorded. RESULTS:Patients had an average age of 14.9 years at the time of surgery. An average of 1.8 filling sessions were required with a mean of 220 cc of fat injected per breast. Patients were followed for an average of 21 months postoperatively. No serious complications were noted. All patients reported satisfaction with their final outcomes. CONCLUSIONS: Autologous fat grafting in conjunction with percutaneous fasciotomy and reduction in the nipple-areolar complex is a safe and effective treatment of the tuberous breast deformity in teenage patients. It provides an esthetic result with minimal scarring and high satisfaction rates while eliminating the need for flaps or implants. LEVEL OF EVIDENCE IV: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.
Entities:
Keywords:
Breast deformities; Fat grafting; Lipofilling; Liposculpture; Percutaneous fasciotomies; Rigottomy; Tuberous breast
Authors: Evi M Morandi; Selina Winkelmann; Lucie Dostal; Isabel Radacki; Ulrich M Rieger; Benedikt Bauer; Ralph Verstappen; Dolores Wolfram; Thomas Bauer Journal: Int Wound J Date: 2021-06-09 Impact factor: 3.315