Journal of Capital Medical University ›› 2019, Vol. 40 ›› Issue (4): 656-660.doi: 10.3969/j.issn.1006-7795.2019.04.029

• Clinical Research • Previous Articles     Next Articles

Clinical observation of fat-graft reconstruction by a novel "star flap "and inframammary fold recreation by liposuction

Song Yangang1, Li Facheng2, Huang Guilin1   

  1. 1. Department of Gastrointestinal and Mammary Surgery, First Affiliated Hospital of Medical College of Shihezi University, Shihezi 832000, Xinjiang Uygur Autonomous Region, China;
    2. 18th Department of Plastic Surgery Hospital, Chinese Academy of Medical Sciences, Beijing 100144, China
  • Received:2019-02-15 Online:2019-07-21 Published:2019-07-19

Abstract: Objective To evaluate aesthetic outcomes of nipple reconstruction by a novel designed "star flap" in breast reconstruction with free fat graft after total mastectomy and contribution of an inframammary fold recreation by liposuction to breast shape improvement. Methods From August 2017 to December 2018, 31 patients, present spontaneously to Plastic Surgery Hospital, Chinese Academy of Medical Sciences, who suffered from breast cancer and received unilateral or total mastectomy were included in this study. After breast reconstruction with autologous fat transplantation, a local star shaped flap was raised. There were 19 cases in the study group. Rolled free dermal-fat matrix harvested subcutaneously from reconstructed breast was implanted within the core of flap. Meanwhile, an inframammary fold was reconstructed by local liposuction.In the control group, 12 patients were randomly selected for breast reconstruction with autologous fat transplantation alone, without nipple and submammary fold reconstruction.At 7 days, 3 months and 6 months after reconstruction, the safety and effect was conducted to evaluate the efficacy of the outcomes. Results All patients who received nipple and inframammary fold reconstruction recovered well after surgery. Among them, 1 case had poor wound healing, respectively, after operation no nipple necrosis was found. Position of the reconstructed nipple were symmetrical with the contralateral side Shrinkage of the nipple projection was continuously observed, which resulted a more nature projection after 6 months. The degree of satisfaction (very satisfactory, satisfied, basically satisfied, unsatisfactory, very unsatisfactory) in the study group was 26.3%, 52.6%, 22.9%, 5.3% and 0%, respectively,while that in the control group was 0%, 18.1%, 45.5%, 36.4%, 8.3%,(Z=3.451, P=0.01). There was statistical difference in the distribution of satisfaction effect between the two groups.Conclusion The star flap buried with dermal-fat plug showed good postoperatively.In combined with inframammary fold recreation with liposuction,the design method is simple, easy to manipulate during the operation, and has good aesthetic quality after the operation. It can significantly improve patient satisfaction and is worthy of clinical application and promotion.

Key words: nipple reconstruction, inframammary fold reconstruction(IMF), star flap, dermal-fat

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