RESUMEN
BACKGROUND: Autogenous fat grafting (AFG) is an established technique used as an adjunct to breast augmentation (BA) to redesign breast shape. Surgeons often use experience and intuition to estimate AFG volume, which can result in incorrect assessment of donor areas and unnecessary fat removal. OBJECTIVES: This aim of this study was to develop a method based on a mathematical formula, which utilizes implant volume and projection to predict AFG volume. METHODS: Thirty patients (60 breasts) underwent primary hybrid BA. A software package (SketchUp) was used to simulate 3-dimensional AFG and implant volumes, which in turn were used to develop an equation for estimating AFG volume according to 3 different implant projections. The results for each group were compared, via Pearson's correlation coefficient, with the results of the clinical series. RESULTS: All patients received Motiva Ergonomix SmoothSilk/SilkSurface implants, ranging in volume from 175 to 355 cc (mean, 265 cc), as well as an average AFG volume of 79.2 cc/breast (range, 50-110 cc). Twenty-nine patients (96.6%) were either very satisfied or satisfied during a mean follow-up of 18 months (range, 6-28 months). A high correlation was observed between the AFG performed in the cohort and predictions obtained from the formula (râ =â 0.938, Pâ <â 0.001). CONCLUSIONS: The AFG volume in hybrid BA procedures can be estimated utilizing measurements based on implant volume/projection. This low-cost method can be applied to guide surgical decision-making in patients who are candidates for BA.
Asunto(s)
Implantes de Mama , Mamoplastia , Mama/diagnóstico por imagen , Mama/cirugía , Humanos , Satisfacción Personal , Trasplante AutólogoRESUMEN
Dentre as malformaçöes congênitas, as fissuras faciais ocupam o segundo lugar, precedidas apenas pelo pé torto congênito. Embora facilmente reconhecíveis, estas anomalias exigem uma abordagem complexa multidisciplinar. Com o objetivo de avaliar este atendimento no Hospital de Clínicas de Porto Alegre (HCPA), foram estudados todos os casos de fissuras faciais nascidos neste hospital no período entre 1983 - 1987. Foram utilizados como fonte os registros de nascimento no centro Obstétricos e dados do ECLAMC (Estudo Colaborarivo Latino de mal Formaçöes Congênitas). Ocorreram 10 casos de fissuras lábio-palatina em 12.313 nascimentos (1:1231). Porém um número bem maior de pacientes com esta anomalia foram operados no hospital durante o mesmo período. Os prontuários destes últimos mostraram falhas importantes de preenchimento. Frente a inexistência de um serviço específico voltado para o tratamento desta anomalia, propomos a utilizaçäo de um protocolo de avaliaçäo e conduta que envolve profissionais de diferentes áreas, as quais säo de valor decisivo para o aocmpanhamento e tratamento dos portadores de fissura lábio-palatina