chapter  25
18 Pages

Surgical Principles and Breast Imaging and Monitoring after Autologous Fat Transfer

Adipose tissue is a highly specialised connective tissue, composed of a major lipid-lled cell type, the adipocyte that is surrounded by stromal vascular cells (SVCs) such as broblasts, immune cells, collagen bres, and blood vessels. Adipocytes are connected by a highly organised extracellular matrix (ECM) thus forming the fat lobules. There are two forms of adipose tissue: brown and white. In humans, brown adipose tissue, so called because of its colour, attributed to its high vascularisation, is predominantly found during the neonatal period and is responsible for producing heat from triglycerides. During the ageing process, brown fat is progressively replaced by white adipose tissue [6]. The latter, composed of adipocytes with a single large lipid inclusion and a large peripherally located nucleus, represents thus the predominant type of fat in humans. It is specialised in a variety of physiological processes including the storage of energy-rich triglycerides, cushioning of vital structures and organs, metabolic homeostasis, immunity, regulation of proliferation, and angiogenesis [4,41], as well as it serves to impart a normal appearance. Hence, fat tissue inuences metabolic homeostasis by producing a variety of hormones, cytokines, growth factors, and other

25.1 Autologous Fat Tranfer ......................................................................................................... 431 25.1.1 About Adipose Tissue ............................................................................................... 431 25.1.2 History of Lipolling ................................................................................................ 432 25.1.3 Fat Grafting-Related Events ..................................................................................... 433 25.1.4 Diagnostic Imaging of Subcutaneous Fat Tissue ...................................................... 433

25.2 Fat Grafting in Breast Reconstruction .................................................................................. 434 25.2.1 Fat Grafting in Breast Augmentation ....................................................................... 436 25.2.2 Diagnostic Imaging in Breast Fat Autologous Transplantation ................................ 436

25.2.2.1 Findings ..................................................................................................... 436 25.2.2.2 MRI Perspectives ....................................................................................... 439

25.3 Fat Grafting for Burn Outcomes and Chronic Ulcers .......................................................... 441 25.4 Fat Grafting in the Management of Contour Irregularities Following Aesthetic Procedures ..... 443 25.5 Fat Grafting-Related Complications ....................................................................................444