Breast hypoplasia is defined by breasts of insufficient volume in relation to the patient's morphology. It can exist immediately (small breasts since puberty) or a hypotrophy can appear secondarily, following a significant weight loss or pregnancy. Hypotrophy can be isolated or associated with ptosis (i. e. breast subsidence).
The treatment of breast hypoplasia most often consists in correcting the volume of the breasts considered insufficient by placing implants (prostheses) behind the mammary gland or behind the pectoralis major muscle. In some cases, this procedure can be associated with a skin lift (ptosis cure).
In some cases it is now possible to increase or restore breast volume by fat transfer.
This technique was initially developed in breast reconstructive surgery where it has made considerable progress.
It is derived from the technique of fat transfers on the face, which is also called lipostructure or lipofilling or lipomodelling.
As a result of the experience acquired in breast reconstructive surgery, the technique has gradually been codified and improved to become a technique in its own right.
To be performed in accordance with the proven facts of science, it must be performed in a surgical setting by a plastic surgeon. The practice of this technique outside the previously defined surgical framework is considered dangerous for patients.
Although it is now clearly established that, as in any aesthetic or non-esthetic breast surgery (removal of benign or malignant tumours, breast reduction surgery, augmentation surgery, etc.), radiological calcifications may appear (related to tissue healing), these calcifications (macro and microcalcifications) are different from those observed in breast cancers and do not pose any diagnostic problems for experienced radiologists.
In addition, modern fat transfer techniques allow a harmonious distribution of adipocytic grafts, making the risk of oily cyst formation or poor setting (cytosteatonecrosis) more limited.
Duration of hospital stay
1 to 2 days.
This surgery requires a short hospital stay of about 12 to 24 hours.
Average length of stay
It's a complex surgery."
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The therapeutic project is developed jointly between the patient and the surgeon.
In particular, the expected aesthetic benefit, the limits of the technique in terms of volume gain, advantages, disadvantages and contraindications will be discussed.
A meticulous clinical and photographic study is carried out.
Each surgeon adopts a technique that is unique to him/her and that he/she adapts to each case to obtain the best results.
The surgeon begins by accurately identifying the fat harvesting areas and recipient sites. The choice of these sampling areas depends on the excess fat areas and the patient's wishes, because this sampling allows a significant improvement of the areas by achieving a real liposuction of the excess fat. The choice of sampling sites is also based on the amount of fat considered necessary and the available sampling sites.
The fat tissue is removed atraumatically through small incisions hidden in the natural folds using a suction cannula (a technique derived from liposuction). Then centrifugation is carried out in order to separate the intact fat cells that will be grafted from the elements that are not graftable (serosities, oil).
The transfer of fatty tissue is made from incisions of 1 to 2 mm using micro-canulas. Fat micro-particles are transferred in different planes (from the rib plane to the skin) along many independent paths (realisation of a real three-dimensional network) in order to increase the contact surface between the implanted cells and the recipient tissues, which will ensure the survival of the grafted adipose cells and thus the "grafting grip".
Insofar as it is a real living cell transplant (the grip of which estimated to be 60 to 70% depending on the patient), the transplanted cells will remain alive. Aesthetic lipomodelling is therefore a definitive technique since the fat cells thus grafted will live as long as the tissues around them. On the other hand, the evolution of these fat cells depends on the patient's adiposity (if the patient loses weight, the volume supplied will decrease).
The duration of the intervention depends on the number of donor sites, the amount of fat to be transferred and any change in position. It can vary from 1 hour to 4 hours depending on the case.
In the post-operative period, pain is generally moderate, but can transitionally be quite strong in the sampling areas. Tissue swelling (edema) at the sampling sites and breasts appears during the first 48 hours after the procedure, and generally takes 1 to 3 months to resolve. Bruises appear in the first few hours in the fat collection areas: they disappear within 10 to 20 days after the operation.
Some fatigue may be felt for one to two weeks, especially in the case of fat collection and significant liposuction.
The operated areas should not be exposed to the sun or UV rays for at least 4 weeks, which would imply the risk of skin pigmentation. After resorption of the phenomena of oedema and bruising, the result begins to appear within 1 month after the operation, but the result close to the final result requires 3 to 6 months.
The use of a qualified MEDICAIM Plastic Surgeon trained in this type of intervention ensures that he/she has the necessary training and competence to know how to avoid these complications as much as possible; and if they occur, to treat them effectively.
In case of dissatisfaction, some of these imperfections may be corrected surgically after a few months.
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MEDICAIM organizes your entire stay for you: post-operative nursing care, biological follow-up, therapeutic, nutritional and psychological support.
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Lipomodelling of the breasts, although carried out for essentially aesthetic reasons, remains a real surgical procedure, which implies the risks associated with any surgical procedure, however minimal it may be.
Complications related to anesthesia must be distinguished from those related to surgery.
In fact, real complications are rare after a quality lipomodelling: a great discipline in the application of the indication and in the surgical realization is required to ensure effective and real prevention in practice.
Infection is normally prevented by prescribing preoperative antibiotic treatment. In the event of a rare occurrence, it will be treated with antibiotic therapy, ice and by removing the point located opposite the area in ammonia. The resolution is then done in about ten days, usually without any significant impact on the final result.
A pneumothorax can occur exceptionally and must then be the subject of specific treatment if it is important (drainage). Injury to the underlying intra-thoracic organs (heart vessels) is theoretically possible but has never been found in normal practice by a surgeon trained in this technique.
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