[Radiological evaluation of breasts reconstructed with lipomodeling]

We have been using the lipomodeling technique since 1999 in order to improve the form and the volume of the breasts reconstructed with latissimus dorsi flap. During several recent years this technique has known a considerable development and its results are quite attractive. At the same time, the breast imaging remains to be a fundamental mean of cancer control. The knowledge of radiological manifestations of the implanted fat tissue is very important. The aim of this study was to evaluate the imaging aspects of lipomodeling in breasts reconstructed with latissimus dorsi flap, using three types of explorations: ultrasound, radiological mammography and MRI. A total of 30 patients were included into the study with average age of 51 years. All of these patients underwent a breast reconstruction using a latissimus dorsi flap with lipomodeling, which average volume reached 165 cc. Four of the patient had a bilateral breast reconstruction. Three modes of imaging (ultrasound, mammography and MRI) were performed a year after the surgery. In 20 patients the imaging findings proved to be normal (in total 34 breasts). An image of fat tissue was revealed in 14 cases and some benign microcalcifications were found in 4 patients. A suspicious tissular image was discovered in one patient, who later underwent a biopsy. The result was a benign giant cell granuloma. In conclusion, the lipomodeling technique does not affect the postoperative follow-up of the patients with breast cancer and an imaging controlled biopsy is possible in case of any doubt. At present, some additional studies are underway evaluating the fat tissue transplants in normal breasts, in order to widen its indications in the plastic breast surgery.