Volumetric assessment of breasts in patients undergoing fat grafting with pre-operative expansion (BRAVA^®): experience of Santa Casa de São Paulo

ABSTRACT

Introduction:

Autologous fat graft possesses the desired qualities of a filling material. However, the largest barriers to its further development are unpredictable results and high rate of absorption of the grafted fat over time. The objective is to perform a volumetric assessment of the breasts in patients undergoing fat grafting using pre-operative external expansion (BRAVA®).

Methods:

Nineteen patients were operated between March 2012 and June 2015 in the Service of Plastic Surgery, Santa Casa de São Paulo. The parameters evaluated using nuclear magnetic resonance (pre-operatively and 6 months post-operatively) were the following: augmented volume=postoperative volume - pre-operative volume; percentage of augmentation=augmented volume/pre-operative volume x 100; percentage of integration=augmented volume/volume grafted x 100.

Results:

The average volume of the breasts in the preand post-operative periods were 294.73 ml and 458.42 ml, respectively. The average graft volume was 274.4 ml (150-350 ml). The following parameters were assessed: average volume augmentation, 168.42 ml (90-270 ml); average percentage of augmentation, 58.98% (23-90%); and average percentage of integration, 62.36% (30-80%).

Conclusion:

The use of external expansion (BRAVA®) in breasts was effective in increasing the rates of integration of the fat grafts and the overall augmentation in breast volumes.

Keywords:
Graft Survival; Tissue expansion devices; Mammoplasty; Autografts