INTRAOPERATIVE FAT GRAFTING INTO THE PECTORALIS AND LATISSIMUS DORSI MUSCLES-NOVEL MODIFICATION OF AUTOLOGOUS BREAST...

Area of Science:

• Plastic Surgery
• Reconstructive Surgery
• Breast Reconstruction

Background:

• The latissimus dorsi flap is a common breast reconstruction method but has limited tissue volume.
• Secondary breast reconstruction often requires methods to augment tissue volume.
• This study investigates an extended latissimus dorsi flap combined with fat grafting.

Purpose of the Study:

• To evaluate the efficacy of extended latissimus dorsi flap with immediate fat grafting for secondary breast reconstruction.
• To assess the safety and outcomes of fat grafting into the pectoralis and latissimus dorsi muscles.

Main Methods:

• 14 patients underwent secondary unilateral total breast reconstruction using an extended latissimus dorsi flap and primary fat grafting.
• Fat was injected under visual control into the pectoralis major and latissimus dorsi muscles.
• Fat injection into the pectoralis muscle created an "autoprosthesis" effect.

Main Results:

• Mean patient age was 48.2 years; mean injected fat volume was 86.4 ml.
• All flaps healed without complications; no fat grafting-related issues were observed.
• Donor site seroma occurred in 57.1%; fat cysts and necroses were lower in muscle than subcutaneous layers.

Conclusions:

• Immediate fat transfer into muscles enhances breast volume with extended latissimus dorsi flaps, avoiding implant issues.
• Pectoralis and latissimus dorsi muscles are safe and reliable recipients for fat grafting in breast reconstruction.