Lipoexnertia retropeitoral em mamoplastia: análise da taxa de integração de gordura com ressonância magnética
Data
2021-11-24
Autores
Guimarães, Paulo Afonso Monteiro Pacheco 
Orientadores
Sabino Neto, Miguel
Tipo
Tese de doutorado
Título da Revista
ISSN da Revista
Título de Volume
Resumo
Introdução: A lipoenxertia pode ser associada à mamoplastia, na tentativa de melhorar o preenchimento do polo superior e para o aumento das mamas. A sua eficácia ainda é questionada devido à imprevisibilidade dos resultados. A dificuldade em isolar a gordura enxertada e diferenciá-la dos tecidos da área receptora pode comprometer a avaliação de sua integração. A região entre os músculos peitorais é um plano livre de gordura, já descrita para colocação de implantes mamários e para lipoenxertia em cirurgias mamárias. Objetivo: Avaliar, com ressonância magnética, a taxa de integração do enxerto de gordura retropeitoral em mamoplastias. Método: Foram selecionadas 30 pacientes com flacidez mamária, candidatas à mamoplastia. Durante a mamoplastia, procedia-se o enxerto, em plano retropeitoral, de gordura coletada do abdome, por lipoaspiração. As pacientes submeteram-se à ressonância magnética pré-operatória, três e seis meses após a cirurgia. Para cálculo do volume de gordura observado em cada exame, foram multiplicados os valores do maior eixo vertical, horizontal e anteroposterior, pela constante 0,523. Resultados: Vinte e cinco pacientes concluíram o estudo. O volume médio enxertado foi de 116,4ml (+22,5ml) por mama. O volume médio aferido da gordura enxertada no plano retropeitoral após seis meses foi de 48,1ml (+25,7ml), e a taxa de integração variou de 38,33% a 40,82%, após três e seis meses da cirurgia. A taxa de complicações relacionadas à lipoenxertia foi de 8%. Conclusão: A lipoenxertia retropeitoral em mamoplastias apresentou taxa de integração de 40,82% na avaliação com ressonância magnética seis meses após a cirurgia.
Introduction: Fat grafting may be used in combination with mammoplasty as an attempt to improve upper pole projection and breast augmentation. The effectiveness of this procedure remains in question due to unpredictable results. Difficulty in detecting and differentiating the grafted fat from host tissues may hinder the assessment of graft integration. The plane between the pectoral muscles, where fat is absent, has been used for implant placement and fat grafting in breast surgery. Objective: To evaluate the integration of retropectoral fat graft in the breast using magnetic resonance imaging. Method: Thirty candidates for mammoplasty with breast flaccidity were selected for the study. During mammoplasty, fat graft was harvested from the abdomen via liposuction and injected into the retropectoral plane. The patients were examined preoperatively and three and six months postoperatively with magnetic resonance imaging. For each examination, fat volumes were calculated by multiplying together the three maximal diameters in the transverse, anteroposterior and longitudinal axes views and by the constant 0.523. Results: Twenty-five patients completed the study. The mean volume of grafted fat was 116.4 ml (±22.5 ml) per breast. The mean volume of fat graft retained in the retropectoral plane was 48.1 ml (±25.7 ml) at six months postoperatively, and graft integration rate ranged from 38.33% to 40.82% after three and six months of surgery. The complication rate associated with fat grafting was 8%. Conclusion: Retropectoral fat grafting to the breast showed an integration rate of 40.82% at six months after surgery, as determined by magnetic resonance imaging.
Introduction: Fat grafting may be used in combination with mammoplasty as an attempt to improve upper pole projection and breast augmentation. The effectiveness of this procedure remains in question due to unpredictable results. Difficulty in detecting and differentiating the grafted fat from host tissues may hinder the assessment of graft integration. The plane between the pectoral muscles, where fat is absent, has been used for implant placement and fat grafting in breast surgery. Objective: To evaluate the integration of retropectoral fat graft in the breast using magnetic resonance imaging. Method: Thirty candidates for mammoplasty with breast flaccidity were selected for the study. During mammoplasty, fat graft was harvested from the abdomen via liposuction and injected into the retropectoral plane. The patients were examined preoperatively and three and six months postoperatively with magnetic resonance imaging. For each examination, fat volumes were calculated by multiplying together the three maximal diameters in the transverse, anteroposterior and longitudinal axes views and by the constant 0.523. Results: Twenty-five patients completed the study. The mean volume of grafted fat was 116.4 ml (±22.5 ml) per breast. The mean volume of fat graft retained in the retropectoral plane was 48.1 ml (±25.7 ml) at six months postoperatively, and graft integration rate ranged from 38.33% to 40.82% after three and six months of surgery. The complication rate associated with fat grafting was 8%. Conclusion: Retropectoral fat grafting to the breast showed an integration rate of 40.82% at six months after surgery, as determined by magnetic resonance imaging.