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June 28-29, 2019 | Oslo, Norway
Page 27
Journal of Medical and Health Sciences | ISSN : 2319-9865
Joint Event
Volume 08
Breast Pathology & Cancer, Gynecology & Obstetrics Pathology, Palliativecare & Gerontology 2019
Breast Pathology & Cancer
Palliativecare & Gerontology
Gynecology and Obstetrics Pathology
Kais Razzouk, RRJMHS 2019, Volume 08
Autologous fat grafting to the postmastectomy irradiated
chest wall - A new way for minimal invasive breast
reconstruction: A series of f ifty four patients
Introduction:
Breast reconstruction after total mastectomy and irradiation
is a real challenge for the surgical teams and is a crucial step for the patient
in the life after breast cancer. The effect of radiotherapy on the skin often
leads to preferring the reconstructions by flaps. However, reconstructions
by prosthesis carry a high risk of complications and unsatisfactory cosmetic
results. The optimization of skin trophicity by lipofilling and its positive
impact on the results of secondary prosthetic breast reconstruction
led us to perform an autologous fat grafting prior to secondary
implant breast reconstruction after mastectomy and radiotherapy.
Patients & Methods:
All patients were treated at the same center
between 2012 and 2015. They all had a total mastectomy and
irradiation. They all had one or more sessions of lipofilling prior to
breast implant reconstruction. Patients were followed to collect this
data: postoperative complications, prosthesis removal, cosmetic result,
and tumor recurrences. Fifty-four patients were included in the study.
Results:
The mean pre-pectoral lipofilling session was 1.1 (1-2). The average
volume of fat injected is 150 cc (80-250). The average time between the
end of treatment and the first session of lipofilling is 20.4 months (3-60).
The mean volume of the prosthesis is 400 cc (290-620). The mean follow-
up time is 22 months. No local tumor recurrence was reported. One
patient had a cutaneous necrosis after lipofilling. Implant explanation was
performed in three cases (5.5%). The mean cosmetic result is 4.7 (3.5-5).
Conclusion:
Pre-pectoral lipofilling prior to implant breast reconstruction
improves the chances of success by optimizing the trophicity of
the skin. It significantly reduces the risk of prosthesis explanation.
Therefore, this protocol allows us to propose a minimal invasive
breast reconstruction, with no additional scar and no additional pain.
Biography
Kais Razzouk is a Specialist in Women’s Oncology. He is concerned with breast disease,
from surgery for benign or malignant diseases to breast reconstruction, is also a Specialist in
gynecological cancers, having a global multidisciplinary approach using minimally invasive
surgery. Since 2006, he has joined the Haute-Normandie Center for Cancer Research as a Cancer
Surgeon. He has been Manager and Advisor in Onco-Gynecology focusing above all on women's
cancer care and more particularly breast cancer. He has participated in the development of certain
surgical techniques which he applies to breast cancer care. The aim is to minimize the patients’
physical and psychological pains, to preserve their self-image by paying particular attention not
only to their cancer results but also the aesthetic side.
cabient.razzouk@gmail.comKais Razzouk
Institut du Sein-Nice Santa Maria, France