Langzeitevaluation nach autologer Fetttransplantation zur Brustvergrößerung

Zusammenfassung

Hintergrund Die Transplantation autologen Fettgewebes ist eine vermehrt angewandte, jedoch nicht standardisierte Prozedur in der plastischen und rekonstruktiven Chirurgie. Bisher gab es lediglich Untersuchungen zu kurzfristigen Ergebnissen über den Volumenerhalt nach einer Fettgewebstransplantation. In dieser Arbeit werden die Ergebnisse einer Langzeitstudie über Fettgewebstransplantationen zur Brustvergrößerung vorgestellt.

Patienten/Material und Methoden Bei 14 Patientinnen wurde präoperativ sowie 5–9 Jahre (Median 6 Jahre) nach der Transplantation autologen Fettgewebes in die Brust nach dem BEAULI-Protokoll ein MRT angefertigt. Die Volumendifferenz wurde mit der Software OsiriX miteinander verglichen. Da zusätzlich die Auswirkung von Gewichtsschwankungen ermittelt werden sollten, wurden die Patientinnen in zwei Gruppen eingeteilt. In Gruppe 1 wurden Patientinnen mit einer Gewichtszunahme von < 1 kg/m², in Gruppe 2 Patientinnen mit einer Gewichtszunahme von > 1 kg/m² eingeschlossen. Die mediane BMI-Zunahme lag bei 1,6 kg/m² (Minimal 0 – maximal 3,9). Eine der Patientinnen hatte nach vorübergehender Gewichtszunahme während der Transplantationen wieder ihr Ausgangsgewicht erreicht.

Ergebnisse Die Patientinnen erhielten je nach gewünschtem Endergebnis zwischen einem und 4 Eingriffe, in welchen ein mittleres Volumen von 176 ml Fettgewebe pro Brust pro Eingriff transplantiert wurde. In der ersten Gruppe konnte ein medianer Volumenerhalt des transplantierten Fettgewebes von 74 % (IQA 58 % – 92 %) errechnet werden. In der zweiten Gruppe wurde sogar eine Volumenzunahme von im Median 135 % (IQA 105 % – 318 %) beobachtet.

Schlussfolgerung In der vorliegenden Studie zeigen sich stabile Langzeitergebnisse bei der Einheilungsrate vom transplantierten Fettgewebe. Es konnte eine signifikante Korrelation zwischen Gewichtszunahme und Volumenerhalt des transplantierten Gewebes gezeigt werden. Damit ist auch die teilweise überproportional hohe Volumenzunahme bei einigen Patientinnen zu erklären. Die Transplantation autologen Fettgewebes ergibt die Möglichkeit einer sicheren und effizienten Methode zur Brustvergrößerung. Für eine genauere Aussage sind jedoch weiterführende Studien mit größeren Fallzahlen notwendig.

Abstract

Background The transplantation of autologous fat is an increasingly common but not standardized procedure in aesthetic and reconstructive surgery. Until now only studies about the short-term results after transplantation with autologous fat have been published. In this publication we present our results of a long-term study after fat transplantation.

Patients/Material and Methods 14 patients underwent an MRI investigation which was done before and 5–9 years (mean 6 years) years after aesthetic breast lipofilling according to BEAULI-protocol. The difference in volume was calculated with the open source software OsiriX. Two groups were analyzed separately to calculate the influence of body weight changes in final volume gain. In the first group patients with a stable BMI (increase of less than 1 kg/m²⁾ were included. The second group includes patients with a BMI gain exceeding more than 1 kg/m². The mean increase in BMI was 1,6 kg/m² (minimum 0 – maximum 3,9). None of the patients lost weight.

Results Depending on the desired amount of breast augmentation the patients underwent between one to four operations. An average of 176 ml fat was transplanted per breast and surgery. In the first group a mean volume survival of 74 % (IQR 58 % – 92 %) was observed. In the second group an increase of 135 % (IQR 105 % – 318 %) of the volume of transplanted fat was observed. After an intermediate weight loss one of the patients regained her initial weight.

Conclusion In this study the transplantation of autologous fat renders good long-term results. There is a significant correlation between change of weight and fat transplant volume survival over the years. This also explains the very high increase in breast volume in some patients. Autologous fat transplantation seems to be a safe and efficient method for breast augmentation. For further statements studies with larger number of cases are necessary.

Schlüsselwörter

Autologer Lipotransfer - BEAULI - Volumetrie - Lipofilling - MRT - Brust - Brustvergrößerung

Key words

Autologous fat graft - BEAULI - volumetry - lipofilling - MRI - breast - breast augmentation

Publication History

Received: 12 May 2019

Accepted: 06 May 2020

Article published online:
10 August 2020

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