The Prepectoral, Hybrid Breast Reconstruction: The Synergy of Lipofilling and Breast Implants
Stillaert, Filip B. J. L. MD; Lannau, Bernd MD; Van Landuyt, Koenraad MD, PhD; Blondeel, Phillip N. MD Plastic and Reconstructive Surgery - Global Open: July 2020 - Volume 8 - Issue 7 - p e2966, doi: 10.1097/GOX.0000000000002966
Breast reconstruction modalities are based on autologous tissue transfer, implants, or a combination of both. The aim of an allogeneic breast reconstruction is to minimize the impact of the implant on surrounding tissues to achieve an aesthetically pleasing result. Accurate tissue coverage, proper implant selection, and implant location are the absolute concerns in planning an implant-based reconstruction.
A single surgeon’s experience with the ergonomic, hybrid approach in primary and secondary breast reconstructions is presented. The hybrid approach is based on tissue expansion followed by serial sessions of fat grafting to augment the residual autologous (subcutaneous) compartment. The last step included the insertion of a prepectoral, ergonomic implant to obtain central core projection and additional volume.
The hybrid reconstructive approach is a reliable technique to improve the outcomes in implant-based breast reconstructions. The 2-step, prepectoral approach with expander-to-implant exchange allows better control of the final breast shape, and complications related to submuscular approaches are avoided. Fat grafting adds an autologous benefit to obtain natural results.
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