Аннтотация

© 2018 Russian Electronic Journal of Radiology.All right reserved. In plastic surgery we often have the need for soft tissue volume restoration of different localization, to close congenital or acquired defects as well as associated with agerelated changes in soft tissue. Autologous adipose tissue in many properties is the ideal filler for the correction of the body contour defects. However, despite its advantages, this minimally invasive technique has been secondary to more complex methods of reconstruction - flap transplantation. The main significant drawback of fat grafting is the unpredictable and ineffective survival of transplanted fat (20 to 60%, according to different authors). Currently, factors that can influence the degree of survival of adipose tissue and make it more predictable are being actively studied, in particular, the effect of Leucocyte and Platelet Rich Plasma (L-PRP). Purpose: To prove the stability of transplanted adipose tissue survival with the addition of L-PRP in breast surgery via multispiral computed tomography (MSCT) with the calculation of resorption rate of adipose tissue before transplantation in the early and in late postoperative stages. Materials and methods: In the period from 2013 to 2016, a total of 48 patients underwent surgery at the plastic surgery clinic in I.M. Sechenov First Moscow State Medical University. All patients complained of dissatisfactory appearance of the breast. Patients underwent breast lipofilling in order to correlate contour deformities. Monitoring of adipose autografts consisted of the following methods: MSCT was performed in 12 cases (5 patients after transplantation of pure adipose tissue and 7 patients after transplantation of adipose tissue enriched with L-PRP). Results: The study of the sample volumes and thickness of soft tissues after the transplantation was performed both with and without the addition of L-PRP. A steady increase in the soft tissue thickness in the breast region was revealed and an increase in volume was noted in the main group. At the same time, in patients of the control group three months after surgery a decrease in the volume and thickness of the breast soft tissues was revealed. Conclusions: The results of the study show that the improvement of breast contour after transplantation of adipose tissue both with and without the addition of L-PRP provides a steady increase in the thickness and volume of breast soft tissues. The average loss of adipose tissue after transplantation ranges from 11.62% to 17.13%. The results also confirm that MSCT is an adequate method of visualization of adipose autografts and volumetric changes in the late postoperative period.