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Abstract Recently, lipofilling is being performed either as a part of oncoplastic technique or alone by itself for correction of defects and asymmetry after oncologic breast cancer surgery.
We provide a literature review and view point focus on this novel technique which emphasize on the application on breast cancer reconstruction. Lipofilling; breast cancer; fat harvest Submitted Jan 22, Accepted for publication Feb 18, For over a century, surgeons have used autologous fat to enlarge and reshape the breasts.
Inthe German surgeon Czerny performed the first breast augmentation by transplanting a lipoma from the lumbar region to a breast defect 1.
With the advent of liposuction in the s, large amounts of unwanted fat could be removed from different body areas using small access incisions and a suction cannula.
InColeman published his landmark review of 17 breast augmentation and reconstruction patients who were treated using autologous fat and were followed up with serial photography 3. Some Europeans persisted and continued to push for the technique, though not for cosmetic augmentation.
Application of lipofilling in breast cancer surgery Lipofilling is being indicated for soft tissue defect correction in many sites.
It Breast prothesis coding not only for corrective surgery but also for cosmetic purpose. For breast cancer surgery, we suggest that lipofilling procedure might be advantage in the following situations: Correction of defects and asymmetry following wide local excision or breast conservative surgerywith or without radiotherapy.
Improvement of soft tissue coverage following implant based breast reconstruction. Volume replacement of implants in unsatisfactory oncoplastic breast reconstruction outcomes. Augmentation of volume and refinement after autologous breast reconstruction. Whole breast reconstruction with serial fat grafting.
Oncological safety Experimental studies have shown that adipocytes can stimulate breast cancer cells. At first the oncological safety was considered as a priority problem for lipofilling but many studies now showed the safety of lipofilling as that multicentric study Milan-Paris-Lyon performed by Petit et al.
There were patients and performed lipofilling procedures. The average interval between oncologic surgical interventions and lipofilling was Average follow-up after lipofilling was They observed a low complication rate; the overall oncologic event rate was 5. The overall locoregional event rate was 2.
The median follow up of 56 months from primary surgery and 26 months from the lipofilling had shown no significant local recurrence when compared to patients as a control group However, there is a trend of higher risk of local event in subgroup of ductal carcinoma in situ.
InRietjens et al. They followed patients and found that postoperative complication rates are very low 3. Ninety-nine fat-grafting procedures were performed an average of Inthe French Society of Plastic Surgery SOFCPRE announced that that they would not support the use of lipofilling for treating defects resulting from breast-conserving treatment BCT as a result of the lack of evidence on its oncological safety.
A phase III multicenter randomized, controlled trial is currently taking place in France with the goal of investigating this issue Also the American society of plastic surgeons had set up a task force in ASPS Fat Graft Task Force to assess the indications, the safety and efficacy of autologous fat grafting on patients it showed the risk of malignancy with lipofilling could not be identified due to lack of standardized techniques and randomized controlled trials Eventhough lipofilling seems to be a safe procedure in breast cancer patients.
Longer follow-up and further experiences from large multicentric oncological series are urgently required to confirm these findings.
Efficacy of lipofilling Although several teams published results of total breast reconstruction with repeated sessions of lipofilling, for most authors, the technique remains indicated for local improvement of small defects or asymmetry only Thirty six complications Another study by Illouz and Sterodimas, reported a series of consecutive patients who underwent autologous fat transplantation over 25 years.
Majority of the study population were breast augmentation but also included patients who underwent lipofilling after breast reconstruction and congenital asymmetry, the authors indicted that the majority of patients were satisfied with the results A questionnaire study on 44 patients who had lipofilling after mastectomy and breast reconstruction or breast conserving surgery for cancer in Karolinska University hospital, Sweden focused on the consistency of the breast, the size of the breast, the shape of the breast, the sensitivity of the skin, its quality, and irregularities of the breast.
The result of questionaire revealed an improvement in shape and size after lipofilling and there was only one complication which was liponecrosis 16 While Beck et al.Injuries 1-True or False #1: Superficial injuries such as abrasions or contusions are not coded when associated with more severe injuries of the same site.
In medicine, a prosthesis (plural: prostheses; from Ancient Greek prosthesis, "addition, application, attachment") is an artificial device that replaces a missing body part, which may be lost through trauma, disease, or congenital conditions.
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Does Medicare Cover Cranial Prosthesis. Posted on November 23, by admin in PDF // 0 Comments. AARP health insurance plans (PDF download) requires treatment for breast cancer to cover prosthetic devices or.
Coding and Payment Guide for . ICDCM V is a billable medical code that can be used to indicate a diagnosis on a reimbursement claim, however, V should only be used for claims with a date of service on or before September 30, For claims with a date of service on or after October 1, , use an .
The HCPCS codes range Breast Prosthetics and Accessories LL is a standardized code set necessary for Medicare and other health insurance providers to provide healthcare claims.