Breast Cleavage Remodeling with Fat Grafting: A Safe Way to Optimize Symmetry and to Reduce Intermammary Distance.

Background: In their descriptions of the ideal breast, most studies have focused primarily on the dimensions, shape, and proportions. The distance between the breasts has only very rarely been considered. The intermammary distance and the medial symmetry between the breasts are important parts of the outcome of surgery and have a strong bearing on patient satisfaction.

Endoscopic Delayed Breast Reconstruction With Expanders and Implants via the Axillary Incision Made for Sentinel Lymph Node Biopsy or Lymphadenectomy.

Background: Classic techniques of delayed prosthetic breast reconstruction use the mastectomy scar as an access route. As a result, the filling of the expander must be postponed until the wounds have healed. This creates an asymmetry between the breasts with the volume changes caused by the filling of the expander, which may occur over several weeks and cause considerable discomfort.

Expanded Flaps in Surgical Treatment of Pressure Sores: Our Experience for 25 Years.

Background: Because the ischial region is the main weight-bearing area in sitting, it is one of the areas most frequently affected by pressure ulcers in paraplegic patients resuming the sitting position during the subacute and chronic stages. The techniques described to date have not been able to reduce the high rates of recurrence and flap dehiscence. Other groups have described successful tissue expansion in the treatment of pressure ulcers, but to date, the long-term results of the procedure have not been reported.

Platelet-rich plasma mixed-fat grafting: a reasonable prosurvival strategy for fat grafts?

Background: One of the most interesting developments in practical applications of fat grafting in recent years is the use of prosurvival strategies to improve maintenance of volume. Platelet-rich plasma (PRP) plays a decisive role in the repair and regeneration of different tissues via the activation and secretion of a great variety of growth factors and other cytokines stored in the alpha-granules of the platelets. This review aimed to assess the efficacy of PRP mixed-fat grafting as a prosurvival strategy for fat grafts.

Endoscopic reconstruction of partial mastectomy defects using latissimus dorsi muscle flap without causing scars on the back.

Background: Results obtained with breast-conserving therapy are not always satisfactory. Reconstruction with a pure latissimus dorsi muscle flap is a useful option. The techniques described for endoscopic dissection of the flap create several scars on the back.

Transplant of an autologous platelet gel prosthesis to fill defects after tumor excision.

Background: Tumor excision causes disfigurement in the breast. We present our technique for filling the defect with activated platelet gel, thus avoiding the deformity.

Methods: Between 2006 and 2011, 23 patients (age range, 45-72 years) underwent tumorectomy for breast cancer.

Endoscopically assisted aesthetic augmentation of tuberous breasts and fat grafting to correct the double bubble.

Background: Treatment of tuberous breasts types 1 and 2 must deal with the problem of the pseudo-double bubble in the primitive inframammary fold and also must release the constrictive ring. Two techniques currently are used to overcome these problems, but neither is entirely satisfactory. The first technique, in which the approach is via the primitive inframammary fold, leaves significant scarring when the lower poles expand.

Periorbital rejuvenation to improve the negative vector with blepharoplasty and fat grafting in the malar area.

Purpose: Periorbital rejuvenation is not achieved by upper and lower blepharoplasty alone; the presence of malar atrophy and the excessive length of the lower eyelid may change the face's oval shape, with the progressive formation of the negative vector. We describe our technique combining blepharoplasty and malar fat grafting to reverse the negative vector.

Methods: After thorough anamnesis, we perform the blepharoplasty and canthopexy if necessary.

Breast reconstruction with fat grafting alone.

We describe our technique for breast reconstruction using fat grafting alone in patients with flaccid, elastic skin, via multiple injections of fat tissue. The technique involves following 3 stages: puckering stitches, to remodel the mass each time fat grafting is performed; cone formation-pexia, the creation and lifting of a cone with the tissue from the area; and neoformation of the inframammary fold, in which the cone is anchored in the pectoralis major and the fold at the level of the sixth rib. Using fat grafting and these 3 maneuvers, we obtain satisfactory breast reconstruction.

Treatment of grade 3 tuberous breasts with Puckett's technique (modified) and fat grafting to correct the constricting ring.

Background: Augmentation of tuberous breasts classified as grade 3 is a challenge to surgeons. The authors describe their technique for correcting grade 3 tuberous breasts with a book-shaped opening of the breast, insertion of an anatomic prosthesis, and fat grafting.

Methods: The authors' technique for correcting grade 3 tuberous breasts consists of reducing the areolar diameter and performing a book-shaped opening of the breast, applying a modified version of Puckett's technique.

Fat grafting in postmastectomy breast reconstruction with expanders and prostheses in patients who have received radiotherapy: formation of new subcutaneous tissue.

Background: In secondary mammary reconstruction in irradiated patients, the use of expanders and prostheses is controversial, given that radiotherapy increases tissue fibrosis and capsular contracture. The authors assessed the usefulness of tissue expansion, prostheses, and fat grafting in patients who had received radiotherapy.

Methods: The authors conducted a study of 65 mastectomized patients (age range, 34 to 62 years) who had received radiotherapy with a 6-MeV electron accelerator.