Lipomodelage en reconstruction mammaire

Abstract

Breast Lipomodeling, or Breast Lipofilling, consists in performing a graft of fatty tissue, from an area of the lower body, and moving it to the breast. This method, initially decried, has progressively taken a major place in breast reconstruction. Preoperative information is important: information must be given verbally and also by information forms from the French for French Society of Plastic, Reconstructive and Aesthetic Surgery (SOFCPRE) that can be downloaded from www.plasticiens.org. After the infiltration of adrenalized serum (1mg of adrenaline in 500mL of physiological serum), taking the fatty tissue requires a fine canula, and, non traumatically, applying a light vacuum to the syringe. The tissue is then prepared by a short centrifugation (15s at 3200rotations/s). The transfer has to be done by gently placing fine "fatty spaghettis" in the entire reconstructed breast (3D network). On the end of the fat transfer, fasciotomies are realized to free the fibrous tracts, and 30 to 50mL of tissue are added. The indications of this technique are many. Lipomodeling has progressively taken the center stage in breast reconstruction, and can be applied in addition to all reconstruction techniques. The indication of exclusive lipomodeling are much rarer: patient with very small breast and important steatomery. Ultimately, breast lipomodeling has provided a remarkable solution for the approach of the sequelae of conservative treatment in breast cancer. Finally, lipomodeling of the breast is a major advance in breast reconstruction. It has significantly improved the quality of breast reconstructions, whether autologous, or in combination with a prosthesis.