PROMOTION
Breast augmentation after problems with silicone implants: fat grafting rather than implant exchange
Klaus Ueberreiter MD, Park-Klinik Birkenwerder, Germany
Inge Matthiesen, PhD, talks to Klaus Ueberreiter about complications with silicone implants and how the surgeon can address these in the most effective way.
A 54 ❚ CCORDING TO A
recent publication in the June PRS Journal (Volume 129, Issue 6), the rupture prevalence rate for
PIP implants after 10 years is 24%. The most common complication with all kinds of silicone implants is capsular contracture, which has an incidence rate of 10% of Baker III and IV cases within 10 years.
Dr Ueberreiter, you are routinely treating patients suffering from capsular
contracture with
autologous fat collected by water-jet assisted liposuction, the so-called BEAULI® Method. Can you tell us something about your experience?
With increasing numbers of patients with silicone implants for breast augmentation or reconstruction, we are confronted by more and more cases of capsular contracture and other problems. For most patients this means disfiguration and pain,
and frequently, the constant fear of reoccurrence. Removing the implants and fat grafting using the BEAULI method is by far the best solution to be offered to those patients.
What are the advantages of this new method? This one-stage procedure of implant removal and lipofilling proved to be highly efficient and fast, with good to excellent results and high patient satisfaction. The time of the overall procedure is 70 (± 15) minutes.
Can you give us some details on your treatment? In our first 30 patients we removed the implants and grafted an average gross volume of 260 ml of fat tissue per breast without performing capsulectomy. The shape of the breast changed to a more natural form and feel. Negative side-effects such as oily cysts did not occur; in two cases we saw small granulomas with a diameter of approximately 5 mm, which mostly disappeared spontaneously after 1 year.
the BEAULI method is the best solution.
and f“Removing implants ”
What are the key points of the new procedure? The procedure includes implant removal and lipofilling of the subcutaneous and intramuscular space in one step. The procedure consists of mainly two principles — fat harvesting and fat collection. For harvesting we use water-jet assisted liposuction with the body-jet®, a device for simultaneous infiltration
July/August 2012 |
prime-journal.com at grafting using
with a water beam and aspiration. A basic infiltration was applied by means of the body-jet® using Range 2–3. The solution used is the classical Klein’s tumescence solution, which is warmed to 37–38°C (98–100°F). After 10 minutes we started liposuction using a 3.8 mm cannula with effective suction openings of 0.9 mm. By adjusting the negative pressure of the body-jet® to -0.5 bar (7 PSI) we avoid damaging the cells. Lower negative pressure is usually ineffective. For fat collection, the
LipoCollector™ is used — a sterile fat collection device which separates the fat from water (tumescence fluid and drugs), rough connective tissue, and other cell debris in a sterile container on the instrumentation table. The washed fat is therefore ready for reinjection.
Do you need centrifugation of the fat tissue before reinjection? Centrifugation is not necessary. It costs a lot of time and destroys part of the cells.
What is your conclusion regarding this new method? Water-jet assisted fat transfer offers a safe, time-saving and effective procedure to treat cases of capsular contracture in which the patients want a soft, natural breast, and do not want new implants.
References
1. Ueberreiter K, von Finckenstein JG, Cromme F, Herold C, Tanzella U, Vogt PM. [BEAULI ® a new and easy method for large-volume fat grafts.] Handchir Mikrochir Plast Chir 2010; 42(6): 379–85
2. Ueberreiter K, Tanzella U, Cromme F. Autologe Fettgewebstransplantation als Salvage-Verfahren nach Kapselkontraktur von Brustimplantaten. von Heimburg Ð Lemperle,
Ë sthetische Chirurgie, 26. Ergˆ nzungslieferung, September 2011
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