[Percutaneous fasciotomies to improve fat grafting into the breast].
BACKGROUND
Breast reconstruction or for breast deformities is a difficult challenge to get excellent results. Lipomodeling technique can improve thoracic malformations and breast deformities. Percutaneous fasciotomies can be an excellent tool for recipient site improvement. The aim of this study is to discuss interest of percutaneous needle fasciotomies with fat grafting into breast surgery.


METHODS
We have realized a retrospective study with fat transfer into the breast surgery. Recipient site prepared fasciotomies during fat grafting surgical procedure. Fat was harvested and centrifugated. Fat was injected into breast reconstructions or thoracic malformations. We did notice: population (age, BMI, uni/bilateral breasts), surgical procedure (mean sessions number, mean fat transfer). Aesthetic aspects of breasts were rated by both surgeon and patient: skin improvement, volume and shape of breast. Each complication was noticed: tissue wounds, scar evolution, hematoma, infection.


RESULTS
We started a retrospective study between 2006 and 2011. One thousand patients were treated with fasciotomies and fat grafting during the same procedure. Main indications were breast reconstruction with latissimus dorsi flap, breast implant reconstruction, breast cancer conservative surgeries, tuberous breast and Poland syndrom. Sessions number expected was between 1 and 3. No complication has been noticed, except 1 tissular wound that needed a medical treatment to solve the problem.


CONCLUSIONS
Fasciotomie is an indispensable complement tool for fat grafting. It is a safe and reliable technique. It improves aesthetic outcomes of breast surgery. Main indications of fasciotomies with fat grafting are breast reconstruction with radiation, breast cancer conservative surgery, and tuberous breast. Percutaneous fasciotomies provide excellent aesthetic result with no scar. They improve the shape of the breast with long-standing result.
Département de chirurgie plastique et reconstructrice, centre régional Léon-Bérard, 28, rue Laennec, 69008 Lyon, France. Electronic address: docteur.hoquoc@gmail.com.
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Ho Quoc
Département de chirurgie plastique et reconstructrice, centre régional Léon-Bérard, 28, rue Laennec, 69008 Lyon, France.
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Michel
Département de chirurgie plastique et reconstructrice, centre régional Léon-Bérard, 28, rue Laennec, 69008 Lyon, France.
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Dlimi
Département de chirurgie plastique et reconstructrice, centre régional Léon-Bérard, 28, rue Laennec, 69008 Lyon, France.
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Gourari
Département de chirurgie plastique et reconstructrice, centre régional Léon-Bérard, 28, rue Laennec, 69008 Lyon, France.
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Meruta
Département de chirurgie plastique et reconstructrice, centre régional Léon-Bérard, 28, rue Laennec, 69008 Lyon, France.
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D000273:Adipose Tissue / Q000637:transplantation*; D000328:Adult; D001943:Breast Neoplasms / Q000601:surgery; D000071938:Fasciotomy; D005260:Female; D006801:Humans; D016462:Mammaplasty / Q000379:methods*; D008875:Middle Aged; D017060:Patient Satisfaction; D012189:Retrospective Studies; D064171:Superficial Back Muscles / Q000637:transplantation*; D013524:Surgical Flaps; D016896:Treatment Outcome
Breast deformities; Breast reconstruction; Fasciotomies percutanées; Fat grafting; Malformations du sein; Percutaneous fasciotomies; Reconstruction mammaire; Sein tubéreux; Transfert graisseux; Tuberous breast