Lower rates of lipofilling sessions in latissimus dorsi flap breast reconstruction with initial higher volume transfer by preservation of subfascial fat: A 3D camera-assisted volumetric case series

Alessio Stivala (1) , Baptiste Bertrand (2, 3) , Neil Ouar (1) , Marc Revol (1) , Michael Atlan (1) , Sarra Cristofari (1)

1 CHU Tenon [AP-HP]
2 C2VN - Centre recherche en CardioVasculaire et Nutrition = Center for CardioVascular and Nutrition research
3 LA CONCEPTION - Hôpital de la Conception [CHU - APHM]

Breast reconstruction with latissimus dorsi flap (LDF) is a well-known technique, but the crucial goal is to achieve a satisfying final volume restoration.Our hypothesis is that LDF reconstruction with the preservation of subfascial fat can achieve a higher volume in a one-time procedure than that achieved in a classic LDF harvest.The aim of the study was to quantify the volume resorption in LDF reconstructions with the preservation of subfascial fat. Fifteen breasts were reconstructed with a simple LDF and the remaining 15 with an LDF with the preservation of the subfascial fat between January 2016 and May 2017. Secondly, every patient underwent a lipofilling procedure. A supplemental lipofilling procedure was performed in unsatisfying cases. A Structure-Sensor camera manufactured by Occipital (R) was used. Each patient received a 3D measurement during immediate postoperative care and then after 3 and 6 months of follow-up.This study shows no difference in volume retention at follow-up between the 2 techniques. The gain of an immediate and stable fatty layer in LDF + subfascial fat technique leads to breast volume improvement in one surgical step. Breast reconstruction with LDF and subfascial fat can be defined as a reliable solution, which provides an optimal result with a reduced number of surgical interventions when compared with a simple LDF. (C) 2019 British Association of Plastic, Reconstructive and Aesthetic Surgeons.

Keywords: Breast reconstruction; Lipofilling; Breast cancer; Latissimus; Dorsi flap; Volumetric study; 3D camera

Domains: Life Sciences [q-bio]; Life Sciences [q-bio]; Human health and pathology

Alessio Stivala, Baptiste Bertrand, Neil Ouar, Marc Revol, Michael Atlan, et al.. Lower rates of lipofilling sessions in latissimus dorsi flap breast reconstruction with initial higher volume transfer by preservation of subfascial fat: A 3D camera-assisted volumetric case series. Journal of Plastic, Reconstructive and Aesthetic Surgery, 2020, 73 (4), pp.681-689. ⟨10.1016/j.bjps.2019.11.002⟩. ⟨hal-03190958⟩