超滤吸附技术应用于大容量自体脂肪移植隆乳的效果评价

Study on improving the effect of large-volume fat grafting breast augmentation using filtration-adsorption technique

目的初步探讨超滤吸附技术应用于大容量自体脂肪移植隆乳的临床效果。方法回顾性分析2020年7月至2021年3月在中国医学科学院整形外科医院乳房整形与美容中心初次行双侧乳房自体颗粒脂肪注射术患者的临床资料。术中应用超滤吸附技术处理脂肪抽吸物并进行双侧自体颗粒脂肪注射移植隆乳(超滤组),以临床目前常用的静置法脂肪纯化方法为对照(静置组)。随访时进行乳房触诊和超声检查,并采用三维扫描技术定量对比术前、术后乳房体积差。对随访3个月以上且数据完整的病例进行统计分析,评估人口统计资料和手术资料,计算并比较2组患者术后乳房体积保持率和并发症发生率。正态分布连续型变量以±s描述,采用t检验进行分析;非正态分布连续型变量以M(Q 1,Q 3)描述,采用Mann-Whitney U检验进行分析;分类数据采用Fisher精确概率检验进行分析,P<0.05为差异有统计学意义。结果共纳入20例女性患者(40只乳房),其中静置组10例(20只乳房),年龄(31.4±2.5)岁,超滤组10例(20只乳房),年龄(28.5±4.4)岁。超滤组脂肪注射量为151.1(125.0,175.0)ml,静置组为165.0(151.3,196.3)ml,差异无统计学意义(P>0.05)。超滤组的术后乳房体积保持率为(62.93±14.06)%,明显高于静置组的(24.97±11.02)%(P<0.01)。术后乳房超声检查时,静置组2只乳房有可触及的结节(<6 mm),1只乳房有超声可探及但临床不可触及的结节(<4 mm),而超滤组仅有1只乳房发现1个油囊(4 mm×2 mm)。超滤组并发症发生率低于静置组,但差异尚无统计学意义[5.0%(1/20)vs.15.0%(3/20),P>0.05]。结论超滤吸附技术能显著提高大容量脂肪移植的体积保持率,减少并发症,是目前一种较理想的脂肪纯化处理方法。

ObjectiveTo preliminarily evaluate the outcome of fat grafting breast augmentation using filtration-adsorption technique.MethodsPatients undergoing autologous fat grafting(AFG)breast augmentation between July of 2020 and March of 2021 were retrospectively reviewed at Breast Plastic and Reconstructive Surgery Center,Plastic Surgery Hospital,Chinese Academy of Medical Sciences,Peking Union Medical College.Patients with complete data who followed up for at least 3 months were included.The lipoaspirates were processed with filtration-adsorption technique and AFG breast augmentation were performed(filtration-adsorption group),and then sedimentation method which was commonly used clinically was set as the control group(sedimentation group).During the follow-up,breast palpation and ultrasound inspection were performed,and the breast volumetric change between preoperative and postoperative was quantitatively compared by three-dimensional scanning technique.Demographic and surgical details were statistically analyzed.Postoperative breast volume retention rates and complication rates were calculated and compared.Normally distributed continuous variables were described in the form Mean±SD,and t-test was used for analysis.Non-normal distributed continuous variables were described in the form of M(Q 1,Q 3)and analyzed by Mann-Whitney U test.The classified data were analyzed by Fisher exact probability test.ResultsA total of 20 female patients(40 breasts)were included,including 10 patients(20 breasts)aged(31.4±2.5)years in sedimentation group and 10 patients(20 breasts)aged(28.5±4.4)years in the filtration-adsorption group.The fat injection volume in the filtration-adsorption group was 151.1(125.0,175.0)ml,and 165.0(151.3,196.3)ml in sedimentation group,respectively,with no statistical significance(P>0.05).The breast volume retention rate in filtration-adsorption group was(62.93±14.06)%,which was significantly higher than that in sedimentation group(24.97±11.02)%(P<0.01).During postoperative breast ultrasound examination,2 breasts in sedimentation group had palpable nodules(<6 mm),1 breast had ultrasonically detectable but clinically inaccessible nodules(<4 mm),while only 1 breast in the filtration-adsorption group had an oil cyst(4 mm×2 mm).The complication rate in the filtration-adsorption group was lower than that in sedimentation group[5.0%(1/20)vs.15.0%(3/20),P>0.05].ConclusionThe filtration-adsorption technique is an ideal method for fat grafting,which would multiply the volume retention rate in large-volume AFG breast augmentation and reduce the rate of complications.