摘要

Objectives: "Hybrid breast augmentation: a must or a plus?" Objectives The presentation mainly focuses on how much lipofilling, combined with implants, can improve results in breast augmentation. Adding fat to reduce implant visibility and smoothen the shape of round implants can positively impact patients' satisfaction, especially in those patients with poor soft-tissue coverage. Introduction: Breast augmentation is one of the most performed procedures in aesthetic plastic surgery. Different implant types and shapes have been developed to fulfill patients' desires for a plump breast with a harmonious shape. Round and anatomical implants are the two main implant shapes available on the market. Even though anatomical implants mimic the natural breast shape are hindered by the risk of rotation, which is the leading cause of reoperation. However, the upper-pole fullness of round implants causes a high risk for implant visibility and step-off deformity, especially in thin patients Materials / method: We performed a hybrid augmentation technique in primary and secondary breast augmentation. Adipose tissue, harvested from the abdomen and lower limbs, was processed according to Coleman's technique and injected into the upper and inner poles of the breast, where round textured implants were inserted. The patients' satisfaction was evaluated with a BREAST-Q test preoperatively, at six months and one year. Results: Our results showed that hybrid augmentation reaches high levels of patient satisfaction and conveys a more natural shape to round implants by helping to reduce implant visibility. The satisfaction for the achieved results is maintained at twelve months. Furthermore, it Improves upper and medial pole fullness, often the desired effects for patients. Adding lipofilling has as the main drawback the prolongation of the operatory time and the rise of costs, but it extends the number of candidates for the use of round implants and sub-glandular augmentation, especially in those with poor coverage. Conclusion: Hybrid breast augmentation may be a valid alternative to the implant-only technique, showing both efficacy and safety in the short term. It is for sure a plus that allows us to refine our technique. However, it shares the same limitations of fat grafting, including non-predictable fat resorption and the possible need for multiple procedures. Therefore, we need longer follow-ups and more prospective studies before considering it a must.