Autologous Tissue Transplantation Research Articles

The Clinical Application of Platelet-Rich Plasma in the Female Reproductive System: A Narrative Review.

Platelet-rich plasma is an autologous plasma containing platelets prepared from fresh whole blood drawn from a peripheral vein. Through processing, it can be prepared to contain supraphysiologic levels of platelets at three to five times greater than the level of normal plasma. PRP has been explored both in vivo and ex vivo in the human endometrium model in its ability to harness the intrinsic regenerative capacity of the endometrium. Intrauterine autologous PRP infusions have been shown to increase endometrial thickness and reduce the rate of intrauterine adhesions. In the setting of recurrent implantation failure, intrauterine infusion of PRP has been shown to increase clinical pregnancy rate. PRP also appears to hold a potential role in select patients with premature ovarian insufficiency, poor ovarian responders and in improving outcomes following frozen-thawed transplantation of autologous ovarian tissue. Further studies are required to explore the potential role of PRP in reproductive medicine further, to help standardise PRP protocols and evaluate which routes of administration are most effective.

Comparison of orthotopic and heterotopic autologous ovarian tissue transplantation outcomes

To compare the outcomes of orthotopic and heterotopic ovarian tissue transplantation techniques. Mixed Prospective-Retrospective cohort study SUBJECTS: 14 recipients of autologous ovarian tissue transplantation INTERVENTIONS: Of the 14 women, 12 who received orthotopic (n=6) or heterotopic (n=6) transplants met the inclusion criteria. All orthotopic transplants and one heterotopic ovarian tissue transplant were performed laparoscopically. While five of six remaining heterotopic transplants were performed subcutaneously under local anesthesia or iv sedation, one was performed with robotic assistance. With the exception of one recipient who solely desired restoration of endocrine function, all underwent oocyte retrieval either to cryopreserve oocytes/embryos before the graft function ceased or because they could not otherwise conceive (hysterectomy, radiation damage, heterotopic transplant). Primary outcome measures were graft function and longevity, and number embryos generated per retrieval. The mean age at ovarian tissue harvesting and at transplantation was lower in the orthotopic vs heterotopic transplant patients, (p<0.001 and p=0.03, respectively) while the proportion of transplanted ovarian cortex was lower in heterotopic transplant cases (p=0.003). All grafts restored ovarian endocrine function. Fertilization rates, the number of embryos generated per retrieval and the mean number of non-arrested embryos were significantly lower in the heterotopic ovarian tissue transplantation (p=0.002, p=0.004 and p=0.01, respectively). However, time to function and graft longevity were similar between the groups. While four of six women conceived and delivered seven children among orthotopic ovarian tissue recipients, one recipient had three spontaneous livebirths after heterotopic ovarian tissue transplantation, presumably due to the induction of function in the remaining menopausal ovary. It appears, orthotopic ovarian tissue transplantation results in higher gamete and embryo quality. However, endocrine function restoration rate and longevity are similar between the two approaches. When feasible, orthotopic ovarian tissue transplantation should be preferred for those who intend to conceive, while a less invasive heterotopic ovarian tissue transplantation can be performed for those who primarily desire ovarian endocrine function.

Oncological Skull Base Reconstruction with Microvascular Tissue Transplantation in Advanced Relapsed Cases

Introduction: Tumors involving the skull base are real challenges to reconstructive surgeons. Many articles have been published about these reconstructions, especially in primary cases. In tumor relapses after previous surgeries or irradiation, the surgical options for reconstruction are extremely narrowed and is our opinion that microvascular autologous tissue transplantation is specially indicated in those patients, even though it requires a technically demanding procedure. Materials and Methods: We analyzed retrospectively all patients treated at our institution between March 2014 and December 2018 and that met all the inclusion criteria: 1) oncological surgery for a tumor involving the skull base; 2) previous surgical treatment for that tumor; 3) cranial base bone resection; 4) dural exposure or defect; 5) reconstruction done with a free flap. The patient's age, comorbidities, number of previous surgeries and/or irradiation, oncological excisional procedures, type of defect, type of reconstruction, postoperative complications and mortality were reviewed. Results: Fifteen flaps were used in the 14 patients that met all the inclusion criteria. The used flaps were: Anterolateral Thigh (ALT) perforator or chimeric ALT/Vastus Lateralis (VL) (n=6), profunda artery perforator (n=3), muscular Rectus Abdominis (n=2), Vertical Rectus Abdominis Myocutaneous (VRAM) (n=2), chimeric osteomuscular scapular tip/Latissimus Dorsi (LD) (n=1) and radial forearm (n=1). Dural defects were reconstructed with Pericranial or fascia Lata grafts in 7 patients. No total flap failures or vascular thrombotic events were noted and just one case of partial flap necrosis was registered (treated conservatively). There was one case of cerebrospinal fluid leakage, one diffuse cerebral edema and one donor site wound dehiscence, all successfully treated with conservative measures. The only complication that required a second operation was a cranioplasty prosthetic exposure that required a second free flap. One patient had a tracheostomy bleeding followed by a pneumothorax and died 8 weeks postoperatively with a nosocomial pneumonia. In the follow-up period, one patient died 19 months postoperatively with a local relapse and another with a metastatic disease (at month 15). Conclusion: Secondary or multiple relapsed cases in the skull base require reconstructions that are technically demanding and the defects are often extensive. The surgical options are extremely reduced by previous treatments and if the basic concepts of cranial base reconstruction were strictly respected, the microsurgical free flaps can offer the best chance to avoid severe complications. However, it is not without some postoperative complications and mortality can be significant in the follow-up because of the advanced stage of the oncologic disease.

Perspectives on the Current State of Bioprinted Skin Substitutes for Wound Healing.

Human skin is particularly vulnerable to external damaging influences such as irradiation, extreme temperatures, chemical trauma, and certain systemic diseases, which reduce the skin's capacity for regeneration and restoration and can possibly lead to large-scale skin defects. To restore skin continuity in severe cases, surgical interventions such as the transplantation of autologous tissue are needed. Nevertheless, the coverage of larger skin defects caused by severe third-grade burns or extensive irradiation therapy is limited due to the depletion of uninjured autologous tissue. In such cases, many of the patient's epidermal cells can become available using biofabricated skin grafts, thereby restoring the skin's vital functions. Given the limited availability of autologous skin grafts for restoring integrity in large-scale defects, using bioprinted constructs as skin graft substitutes could offer an encouraging therapeutic alternative to conventional therapies for large-scale wounds, such as the transplantation of autologous tissue. Using layer-by-layer aggregation or volumetric bioprinting, inkjet bioprinting, laser-assisted bioprinting, or extrusion-based bioprinting, skin cells are deposited in a desired pattern. The resulting constructs may be used as skin graft substitutes to accelerate wound healing and reconstitute the physiological functions of the skin. In this review, we aimed to elucidate the current state of bioprinting within the context of skin tissue engineering and introduce and discuss different bioprinting techniques, possible approaches and materials, commonly used cell types, and strategies for graft vascularization for the production of bioprinted constructs for use as skin graft substitutes.

Safety of ovarian cryopreservation and transplantation in patients with acute leukemia: a case series

With increased success, ovarian tissue cryopreservation has recently become a standard technique for fertility preservation. However, malignant cell introduction through ovarian tissue transplantation remains a major concern for patients with acute leukemias. This study aimed to investigate the safety of performing autologous ovarian tissue transplantation in survivors of acute leukemia. Clinical, histopathological, and molecular data of 4 women with acute myeloid leukemia and 2 women with acute lymphoblastic leukemia who underwent ovarian tissue cryopreservation and transplantation were analyzed in this case series. Following cryopreservation of 66% to 100% of an ovarian cortex with a slow freezing method, all women received high-dose multiagent alkylating preconditioning chemotherapy for allogeneic hematopoietic stem cell transplantation. Before the ovarian tissue transplantation, (1) antral follicle counts, serum antimüllerian hormone and follicle-stimulating hormone levels were assessed to confirm primary ovarian insufficiency; (2) all recipients were cleared by their hematologist-oncologists; (3) representative cortical strips were screened for leukemia infiltration by histologic (hematoxylin and eosin staining), immunohistochemical (CD3, CD20, CD34, CD68, CD117, CD163, PAX-5, Tdt, lysozyme, and MPO), and molecular marker evaluation (BCR/ABL p190 and AML1/ETO) where appropriate. The median age was 20 years (interquartile range, 15-32) at ovarian tissue cryopreservation. Before undergoing hematopoietic stem cell transplantation, all patients received induction or consolidation chemotherapy that included cytarabine+ daunorubicin or Berlin-Frankfurt-Munich-95 protocol and were in remission. The mean serum antimüllerian hormone was 1.9±1.7 ng/mL before ovarian tissue cryopreservation. In all cases, ovarian tissue screening for leukemic cells was negative. Ovarian transplantation was performed laparoscopically with or without robotic assistance, after a median of 74.5 months (interquartile range, 41-120) after ovarian tissue cryopreservation. Ovarian function resumed in all patients after a median of 3.0 months (range, 2.5-4.0), and 2 women had 1 live birth each. The median graft longevity was 35.5 months (interquartile range, 18-57) after ovarian tissue transplantation. After a median follow-up of 51 months (interquartile range, 20-74), all patients remained relapse-free. In 1 patient, the graft was removed during cesarean delivery and was negative for immunochemical leukemia markers. Our long-term follow-up demonstrated no evidence of disease relapse after ovarian tissue transplantation in patients with acute leukemia who received allogeneic hematopoietic stem cell transplantation. This safety profile may be explained by the fact that these patients are induced into remission by nongonadotoxic induction chemotherapy before undergoing ovarian tissue cryopreservation. We propose that ovarian tissue cryopreservation should not be excluded as a fertility preservation option for young women with leukemia who are due to receive preconditioning chemotherapy before allogeneic hematopoietic stem cell transplantation.

Ferroptosis in Autologous Fat Transplantation: A New Hypothesis.

Autologous adipose tissue transplantation is widely used for cosmetic and reconstruction of various areas in the body, often to repair soft tissue volume loss or contoured deformation. However, the application of fat transplantation is limited by unstable and unpredictable volume retention rates. At present, promoting adipose tissue survival and inhibiting its death is the key to improve the effect of autologous fat transplantation. In this paper, we propose a hypothesis that ferroptosis exists in fat transplantation. The bases of this hypothesis include the following: (1) the association between ferroptosis and other programmed cell death; (2) the association between ferroptosis and ischemia-reperfusion injury; and (3) the use of ferroptosis inhibitors in the field of fat transplantation.

Regeneration of the ureter using a scaffold-free live-cell structure created with the bio-three-dimensional printing technique.

Ureteral strictures, which can be caused by ureteral injury, radiation therapy, ureterolithiasis, urinary tract infections, and ureteral endometriosis, typically require ureteral reconstruction. Although tissue engineering, autologous alternative tissue transplantation, and surgical techniques applying various flaps have been carried out for ureteral regeneration, all with some success, each method has its advantages and disadvantages. As an alternative, we created the first artificial ureter structures using only live cells and grafted them into healthy rat ureters. Spheroids were created using normal human dermal fibroblasts and human umbilical vein endothelial cells and subsequently laminated using a bio-three-dimensional printer. After molding the laminated spheroids into tubular structures, the artificial ureters were transplanted into live rats. After 2-12 weeks, the animals were sacrificed and their gross and pathological features were examined. In the artificial ureteral lumen of rats with Grade 0-1 hydronephrosis, regeneration of the ureteral epithelium was observed, the thickness of which increased over the course of the experiment. Regeneration of the muscular layer was also observed, extending from the normal ureteral side toward the artificial ureter structure over time. However, complete regeneration was not observed at the end of 12 weeks. Although ureteral peristalsis was noted in all cases, it was weaker than expected. Therefore, we achieved short-segment ureteral regeneration using a cell-only structure. This finding suggests that by applying alternative strategies to this method, such as changing the cell type and composition, regeneration over the entire length of the ureter may be possible in the future. STATEMENT OF SIGNIFICANCE: Until now, ureteral regeneration techniques have been dominated by the use of high-molecular-weight compounds and autologous tissues, and there have been no reports of regeneration using structures made entirely of cells. This is the first report of ureteral regeneration using a tubular structure made from stacked spheroids. Although this study only attained short-segment ureteral regeneration, regeneration of the ureter over a much longer proportion of its length can be achieved in the future by applying other strategies, such as changing the cell type. This study provides a foundation to achieve the future goal of complete regeneration.

[Re-discussion on the comprehensive treatment strategy of complex ventral hernia from the perspective of intraperitoneal pressure].

Complex ventral hernia refers to a large hernia that is complicated by a series of concurrent conditions. Change in intra-abdominal pressure is one of the main pathways through which various factors exert an impact on perioperative risk and postoperative recurrence. Taking abdominal pressure reconstruction as the core, the treatment strategy for complex abdominal hernia can be formulated from three aspects: improving patients' tolerance, expanding abdominal cavity volume, and reducing the volume of abdominal contents. Improving patients' tolerance includes abdominal wall compliance training and progressive preoperative pneumoperitoneum. To expand the volume of the abdominal cavity, implanting hernia repair materials, component separation technique, autologous tissue transplantation, component expend technique, and chemical component separation can be used. Initiative content reduction surgery and temporary abdominal closure may be performed to reduce the volume of abdominal contents. For different cases of complex ventral hernia, personalized treatment measures can be safely and feasibly adopted depending on the condition of the patients and the intra-abdominal pressure situation.

A new way of repairing special wounds

PurposeWound repair has always been the basic method of burn surgery, but not all wounds in clinical work can regain both function and appearance. For relatively small wounds with irreversible functional damage accompanied by necrotic bone, joint and tendon exposure, and the wounds in non-functional sites with necrotic bone, tendon exposure and poor surrounding tissue conditions, the value and significance of tissue flap transplantation for wound repair are debatable. This paper discusses a new repair method as a supplementary choice for tissue flap transplantation: autologous granulation tissue and autologous thin split-thickness skin graft, which not only repairs the wound in a simple way but also avoids the cost of tissue flap transplantation. MethodsA total of 11 patients were collected from June 2019 to July 2022, with a total of 20 exposed wounds of bone, joint and tendon necrosis. During the operation, the necrotic exposed bone tissue and the completely necrotic tendon tissue were removed, and the necrotic soft tissue around the wound was completely excised until the wound appeared bleeding. We cut granulation tissue from other parts of the patient's body with a thickness of about 0.5–0.8 mm, cover the deep wound after thorough debridement with granulation tissue, and transplant autologous thin split-thickness skin to the deep wound covered with granulation tissue. The surgical area was compressed and immobilized. ResultsIn 11 patients, 20 wounds were surgically treated, and the wounds healed 15–25 days after the operation, and no bone tissue, joints, or tendons were exposed. No case underwent secondary surgery after surgery. Some wounds were treated with bedside allograft with the consent of the patient due to a small amount of residual granulation wound healing after transplantation. ConclusionUsing autologous granulation tissue and autologous thin split-thickness skin transplantation to repair some special wounds can not only repair the wounds simply and effectively but also avoid the cost of tissue flap transplantation.

Reverse Expansion for Breast Reconstruction after Skin-sparing and Nipple-sparing Mastectomy: Our First 100 Cases.

From January 2010 to September 2018, 253 breast reconstruction procedures were performed on 100 patients. The reverse expansion technique consists of autologous fat tissue transplantation requiring the combined use of a skin expander and of multiple lipofilling sessions. At the beginning of every session the breast expander was deflated by removing a saline volume similar to that of the fat to be injected. Overall, 56 breast reconstructions after skin-sparing mastectomy and 44 after nipple-sparing mastectomy were performed. An average of 661.5 cm3 of fat per session was harvested and an average of 305.3 cm3 per breast was injected. The average number of sessions to achieve breast reconstruction was 2.53. Only four complications after 253 procedures (1.5%) were reported: one donor site hemorrhage due to genetic lack of coagulation factors, and three surgical site infections. Considering the large number of positive factors such as a fast postoperative recovery, an easy learning curve, a lack of need of a specialized surgical team, a natural look of the breast shape, and the soft consistency of the grafted tissue, we believe this technique could be the first choice for autologous reconstruction after skin-sparing mastectomy and nipple-sparing mastectomy.

Effectiveness and Safety of Transplantation of the Stromal Vascular Fraction of Autologous Adipose Tissue for Wound Healing in the Donor Site in Patients with Third-Degree Skin Burns: A Randomized Trial.

The quality of the wound healing at the donor site significantly determines the overall condition of the burn patient, the extent of wound fluid and protein losses, the severity of any systemic in-flammatory reaction, and the intensity of the pain syndrome. It is known that the stromal vas-cular fraction (SVF) has a beneficial effect on the healing of wound defects. This study is aimed at assessing the safety and effectiveness of the application of the SVF of autologous adipose tis-sue to stimulate wound healing of the donor site in patients with burns. This placebo-controlled clinical study included 38 patients with third-degree thermal skin burns. The patients underwent liposuction, enzymatic isolation of the SVF, and intradermal injection of the preparation into the wounds in the donor site, followed by tewametry, cutome-try, thermography and biopsy after 12 days. Quantitative indicators were compared using the Mann-Whitney test for unrelated groups and the Wilcoxon test for related groups. Spearman's rank correlation coefficient (RS) was used to assess the correlation. Epithelization of the wounds in all patients was seen over an average area of 88 (84;92) %, there being no significant differences between the actual and the control wound sites for this parameter. Transdermal water loss in the test wound sites was 2 times lower than in the control sites (P = 0.001). The wound donor sites regained their temperature distribution faster than the control sites (P = 0.042). Histological preparations of the skin of the wound sites revealed that their epidermal layer was 19% thicker compared to the controls (P = 0.043). It should be noted that five adverse events related to manipulations in the postoperative period were registered. Transplantation of SVF autologous adipose tissue into the wound area in most clinical cases proceeded without complications. The area of epithelialization of wound areas af-ter the introduction of SVF did not change, although a significant decrease in transdermal water loss was observed in the wound areas with an improvement in their thermoregulation and an increase in the thickness of the epidermis.

Application of acellular dermal matrix in periodontal soft tissue augmentation surgery

The substitute materials of autologous tissue graft for periodontal soft tissue augmentation surgery develop rapidly. The use of substitute material can avoid the second operation area, shorten the operation time, reduce the postoperative reaction and pain, and is not limited by the quantity, suitable for a wide range of cases. In this paper, the characteristics, histological study, clinical application and therapeutic effect of acellular dermal matrix as a substitute material for autologous tissue transplantation were introduced to provide reference for clinical work.

CBCT evaluation of palatal alveolar protuberance in maxillary molars

In recent years, the treatment goal of periodontal disease has developed from the single emphasis on the control of inflammation and improvement of function to the further shaping of oral“Whitening aesthetics”, soft tissue transplantation is an important part of periodontal plastic and implant surgery. Periodontal ligament and gingival surgery based on autologous tissue transplantation has predictability and long-term stability, it has also been widely used in aesthetic prosthodontics of the oral cavity. However, the site of soft tissue defect and the donor site of the palate are different in clinical practice, which leads to the change of the operative procedure. Some patients have bony protrusions on the palatal alveolar ridge of their maxillary molars, which may affect periodontal surgery in these patients. CBCT has become a commonly used examination method in various oral clinical disciplines. It can be used to observe the skull from all angles and has a high clinical acceptance. In this article, we reviewed the research progress of CBCT in palatal measurement of maxillary molars and the feasibility of CBCT in evaluating palatal alveolar protuberance of maxillary molars.

From replantation to transplantation: The evolution of orthoplastic extremity reconstruction.

For more than six decades, the use of the operating microscope for extremity surgery has led to remarkable advances in the management of orthopedic trauma, tumors, infections, and congenital differences. The microsurgical reconstructive ladder ascends from basic microsurgical procedures such as a digital artery or nerve repair to more complex procedures such as autologous tissue transplantation. Functional muscle transfers, toe-to-hand transfers, and recently vascularized composite allotransplantation are the highest rungs on this ladder that help restore extremity function. The development of the orthoplastic approach over the last three decades simultaneously integrates the principles and practices of both orthopedic surgery and plastic surgery for optimal care and salvage of extremities. Clinical, anatomic, and basic science research in reconstructive microsurgery has resulted in significant improvements in extremity salvage, reconstruction, and restoration.

Application of Autological Adipose Tissue and its Products in the Treatment &#x0D; of Infected Wounds of Different Genesis

Introduction. Transplantation of autologous adipose tissue and its products to stimulate the wound process is a rapidly developing area of ​​regenerative medicine. Adaptation of the technology to the conditions of infected wound treatment is a great challenge.The aim of the study was to determine the most effective and safe technologies for obtaining, processing and transplanting autologous adipose tissue used to treat infected wounds.Material and methods. The authors searched for relevant papers published in 2011 to 2021 in electronic databases PubMed, eLIBRARY, Embase, Cyberleninka, Web of Science. The analysis included 30 sources: 5 RCTs, 16 clinical studies, 3 case reports, 1 systematic review, 2 literature reviews, and 4 sources published before 2011 due to their fundamental and practical significance for the scope of the issue.Results and discussions. Although the lipoaspiration procedure in patients with infected wounds is described as standard conventional one, it still has a number of significant features that distinguish it from the standard technology of aesthetic surgery. To treat lipoaspirate, both enzymatic and mechanical options were used with the same frequency. The main technique of introducing adipose tissue products was local intradermal injections into the edges and under the wound bed; in a few cases, applications on the wound surface were used, or a combination of these options. As recorded, the cellularity index of adipose tissue products ranged from (min) 1x104/ml to (max) 50x106/ml. It should also be noted that a unified terminology for adipose tissue products used for wound treatment has not yet been adopted, but the most common term is stromal-vascular adipose tissue fraction.Conclusions. Systematization of literature data on the use of autologous adipose tissue products for wound treatment has shown that at present this technology is safe, provided with an accessible instrumental base, has positive results and is being actively developed. Further randomized clinical trials, involving extensive and multiple wounds, are required to determine the minimum effective and maximum tolerable dose in the treatment of wounds with adipose tissue products. In addition, it is promising to develop new means and approaches for delivering adipose tissue products in the treatment of infected wounds of various origins.

Prevention of Esophageal Stricture After Whole Circumferential Endoscopic Resection: A Review for Endoscopists.

The incidence of esophageal stricture without stricture prophylaxis measures after whole circumferential endoscopic resection is almost 100%, which substantially decreases the patients' quality of life and requires multiple sessions of endoscopic balloon dilation. To date, there are many reports concerning the prevention of esophageal stricture after whole circumferential endoscopic resection. Oral steroid may be effective for preventing esophageal stricture after whole circumferential endoscopic resection. However, exposure to a high dose of steroid raises concerns with regard to adverse events. Intralesional triamcinolone acetonide injection and preventive endoscopic balloon dilation did not appear to reduce the frequency of stricture formation after whole circumferential endoscopic resection. Esophageal stent appeared to be a possible prophylactic treatment, but adverse events should be of great concern. Polyglycolic acid sheets seemed promising, because they can not only act as protective barriers but can also be drug carriers to prevent esophageal stricture. Tissue engineering and regenerative medicine such as oral mucosal epithelial cell sheets cultured in vitro have been used in patients to prevent esophageal stricture, but it is technically and financially burdensome. Autologous tissue transplantation showed a promising preventive effect for esophageal stricture and it is relatively easy to carry out in clinical practice, and this technique needs further improvements to prevent esophageal stricture after whole circumferential endoscopic resection.

IS IT SAFE TO PERFORM OVARIAN CRYOPRESERVATION AND TRANSPLANTATION IN PATIENTS WITH LEUKEMIA A 5-YEAR SURVIVAL ANALYSIS DATA

Although ovarian tissue cryopreservation is performed in patients with leukemia undergoing Allogenic Hematopoietic Stem Cell Transplantation (Allo-HSCT), auto-transplantation of these tissues have raised concerns with the risk of reintroducing cancer cells. We performed this retrospective study, spanning 14 years to investigate the safety of performing autologous ovarian tissue transplantation in acute leukemia survivors.

Reconstruction of the trachea and carina: Surgical reconstruction, autologous tissue transplantation, allograft transplantation, and bioengineering.

There have been significant advancements in medical techniques in the present epoch, with the emergence of some novel operative substitutes. However, the treatment of tracheal defects still faces tremendous challenges and there is, as yet, no consensus on tracheal and carinal reconstruction. In addition, surgical outcomes vary in different individuals, which results in an ambiguous future for tracheal surgery. Although transplantation was once an effective and promising method, it is limited by a shortage of donors and immune rejection. The development of bioengineering has provided an alternative for the treatment of tracheal defects, but this discipline is full of ethical controversy and hindered by limited cognition in this area. Meanwhile, progression of this technique is blocked by a deficiency in ideal materials. The trachea together with the carina is still the last unpaired organ in thoracic surgery and propososal of a favorable scheme to remove this dilemma is urgently required. In this review, four main tracheal reconstruction methods, especially surgical techniques, are evaluated, and a thorough interpretation conducted.

МАММОПЛАСТИКА: ОТ РЕКОНСТРУКТИВНОЙ ДО ЭСТЕТИЧЕСКОЙ ХИРУРГИИ

Mammoplasty is one of the most common operations, both among aesthetic and reconstructive interventions on the mammary gland. Over the past 10 years, the number of women newly diagnosed with malignant tumors of the mammary gland in Russian Federation is annually increasing, on average, by 3.6% (more than 46 thousand new cases): in 2019, 73,918 new cases of breast cancer (BC) were detected. Currently, the treatment of BC involves the removal of the primary tumor, followed by reconstruction of the gland, which plays an important role in the early rehabilitation of patients. In plastic surgery, breast augmentation interventions occupy one of the leading positions with an annual upward trend. The review article presents the history of the development of oncoplastic surgery, justifies the need for primary reconstructive surgery in women with BC, and describes options for radical mastectomies with one-stage reconstruction. Literature data on indications for breast implants, the main methods of augmentation mammoplasty and lifting, and transplantation of autologous adipose tissue enriched with stem cells in severe ptosis are presented; post-lactational or age-related involution of the mammary glands is described. Keywords: Plastic surgery, reconstructive surgery, breast, surgery, cancer.

Autologous adipose tissue transplantation combined with augmentation mammoplasty in aesthetic surgery

<h3></h3> В обзоре представлены данные отечественной и зарубежной литературы, отражающие совместное применение двух методик по увеличению груди — аутоадипотрансплантации и аугментационной маммопластики. Аугментационная маммопластика позволяет успешно решать вопрос увеличения объема, но вместе с тем имеет ряд недостатков, которые влияют на эстетическую составляющую результата. Аутоадипотрансплантация позволяет решать вопросы, связанные с деформацией и асимметрией молочных желез после аугментационной маммопластики, контурированием имплантатов в области медиальных границ у пациенток с астеническим телосложением. Может быть использована в качестве самостоятельной методики маммопластики при необходимости первичного увеличения груди без протезирования, восстановления объема после удаления имплантатов. Вместе с тем у аутоадипотрансплантации есть и ряд недостатков: возможный дефицит донорских и реципиентных зон, риск появления кальцификатов и кист, некроза пересаженной жировой ткани и других осложнений, связанных с хирургическим вмешательством.