날짜: 2012.9.12~9.13 학회: aesthetics asia 2012 - Augmentation Rhinoplasty with Fat and Fat Gel, Fat Grafting to the Breast - Tips on Patient Selection and Getting the Best Results 장소: 싱가폴, marina bay sands Fat grafting to the breast –tips on patient
selection and getting the best results
Heeyoung Lee. M.D., Ph.D., Hyunjin Yang.
M.D. Baroyl & Kangnam Plastic Surgery.,
Seoul, Korea.
Fat
graft for breast have still controversy because of low predictability,
absorption, oil cysts, micro calcifications. Especially in thin patients,
frequently we could not choose fat graft. Even though patients want fat graft
only without any artificial implant, we recommend adjuvant surgery like small
silicone implant or barbed sutures(MISJu ™). The
almost patient want fat graft refuse about silicone implant but, absorbable
threads would be O.K. So we recommend MISJu or 100cc silicone bags for every
breast patients. In Asian patients under 48kg with thin thigh and want fat
graft only, we warn too small volume effects. We have been developed to reduce absorption
and cysts for 10 years. We concluded that old, bigger adipocytes should be
removed before injection because they would die within 2 weeks and pour out
large amount free oil. But larger number of stem cells would turn to grow and
replace the volume. We use (Lipokit™) syringe to select and remove older
adipocytes with squeezing during centrifugation with 100kg pressure on the fat
tissues. Total volume maintenance rates
increased about 20% of conventional methods. As conclusions, 1. Thin patients with less thigh fat;
adjuvant surgery like silicone implant/ MISJu centralization and medialization. 2. Older cell selection removal with 'squeezed
fat', despite of initial 15% harvesting volume loss, but volume maintenance
rate would be over 20% than 'non squeezed fat'. 3. Informed consents about volume
absorption would be necessary. 4. Fine injection technique using 18, 19 G
with micro volus injection. 5. Less delay from harvest to injection. 6. CAL when the fat is enough. In our 12 year experiences, there was one
infection. However cysts is not rare but easily treated with penetrating 'micro
liposuction' with hand pressure, finally there was no problem. We recommend thread surgery as adjuvant
method which also help volume effects and central projection. |