| Background:Autologous fat tissue is considered to be the most ideal filling tissue because of its biocompatibility superior to artificial tissue substitutes,no immunological rejection and abundant in source and inexperience.Autologous fat grafting is prevailingly used for aesthetic and reconstructive surgeries,especially breast augmentation.However,due to cell damage,local blood supply deficiency,and inflammatory reaction,adverse events occur such as absorption,necrosis,liquefaction,and calcification.It is difficult to survive completely.The postoperative fat volume retention rate is difficult to predict.In recent years,scholars have carried out a lot of research on the factors affecting the volume retention rate of autologous fat augmentation,such as fat activity,recipient environment and application of assistive technology,which have improved the fat survival rate to some extent.However,the long-term volume retention rate is still not satisfied.In order to further explore the factors affecting the retention rate,the individual characteristics of patients(such as age,BMI)have become the research hotspots,while the research on the characteristics of pregnancy,lactation,menstrual cycle and menopause is relatively rare.Exploring the effects of these factors is more conducive to the prediction of postoperative outcomes and good communication between doctors and patients.Objective:1.Comparing the effects of lactation history or not on fat volume retention rate;2.Comparing the effects of different stages of the menstrual cycle on the volume retention rate;Methods:A retrospective study was conducted on the cases of autologous fat grafting cosmetic breast augmentation conducted in our center from 2012 to 2018.Cases were screened according to inclusion criteria,and preoperative and postoperative breast volume difference was measured using 3D imaging technology,and the volume retention rate was calculated.1.Comparing the effects of lactation history or not on fat volume retention rate;According to the medical data,patients were divided into two groups,Group A without a history of lactation and Group B with a history of lactation.Independent sample t test and multivariate regression were used for comparison based on patients,level data by SPSS 25.2.Comparing the effects of different stages of the menstrual cycle on the volume retention rate;According to the medical history,record the patient's last menstruation,menstrual cycle and operation date.They were divided into Group A:the follicular group(end of menstruation?10 days),Group B:the ovulatory group(11 to 17 days),Group C:the luteal group(18 to next menstrual cramp).Based on the patient's level data,compare the differences of postoperative volume retention rate by SPSS 25.Results:1.In the group of lactation,the volume retention rate was higher.A total of 70 cases(137 breasts)were included(Group A,n=40;Group B,n=30).Patients without lactation history were younger in age(Group A,25.88years;Group B,36.03years,p<0.05),whereas individuals without a lactation history had a significantly lower mean body mass index(Group A,19.72kg/m2;Group B,20.83kg/m2,p=0.010).The proportion of donor sites were not exactly the same(Group A,abdomen25 percent,thigh 70 percent;Group B,abdomen53.33 percent,thigh 46.67 percent,p<0.05).While the mean volume injected was not significantly difference(Group A,182.79ml;Group B,194.00ml,p>0.05).Eventually,the overall volume retention rate of patients with a history of lactation was significantly higher(Group A,30.42 percent;Group B,41.03 percent,p=0.028).And multivariate regression analysis showed that the results were still statistically significant.2.There might be differences postoperative effects in different operation times.A total of 48 cases(94 breasts),of which 10 patients(18 breasts)in the follicular group(Group A),15 cases(30 breasts)in the ovulatory group(Group B),and 23 cases(46 breasts)in the luteal group(Group C).The mean age was not significantly difference(Group A,29.80 years;Group B,31.73years;Group C,28.91years,p>0.05).The mean menarche age and menstrual cycle are the same as the mean age.The postoperative volume retention rate in ovulation group was significantly different(Group A,26.94%;Group B,49.06%;Group C,35.73%,p<0.05).Multiple comparisons between groups showed that the retention rate was higher in the ovulatory group than the groups of the follicular phase(P<0.05)and the luteal phase(P<0.05).There was no significant difference in the volume maintenance rate between groups of the follicular phase and the luteal phase(P>0.05).Conclusion:1.The volume retention rate after autologous fat graft breast augmentation in the group with a history of lactation was higher than that in the group without a history of lactation(41.03%±17.97%vs.30.42%±20.65%,P=0.028).However,there was no significant difference in the effect of age,BMI,donor area,etc.on postoperative volume retention rate.Hormone fluctuations in women pre and post lactation,changes occurs in breast morphology and function.Whether this period has an effect on the activity of fat,whether the length of lactation has an effect on the outcome,etc.,which need further research to reveal.2.Surgery at different stages of the menstrual cycle may affect the retention of postoperative fat volume.When autologous fat graft breast augmentation was performed during the ovulatory phase,the fat volume retention rate was higher than the other groups.However,due to the small sample size,incomplete medical records,and lack of test data,further research is needed to explore the relationship.This provides a new direction for clinically improving the long-term retention rate of autologous fat graft. |
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