| Abstract | Hibridna rekonstrukcija dojke je zahvat koji primjenom više od jedne rekonstruktivne metode pokušava vratiti anatomski izgled dojci s izraženim deformitetot i pritom što više iskoristiti prednosti svake od korištenih metoda uz istovremeno prekrivanje mana istih individualno primjenjenih metoda. Lipofiling kao svoje prednosti nudi manju invazivnost, prirodniji izgled rekonstruirane dojke, kao i istodobnu mogućnost dobitka volumena u dojci i smanjenja volumena sa mjesta gdje je višak masti nepoželjan. S druge strane, negativne strane lipofilinga su: potencijalna potreba za više korektivnih tretmana (od kojih svaki predstavlja dodatan rizik za pacijenticu), moguća nekroza prenesenog masnog tkiva kao i nemogućnost uzimanja masnog tkiva kod pacijentica sa manjkom istog. Implantati kao svoje prednosti imaju: mogućnost rekonstrukcije u jednom zahvatu, lako predvidljive rezultate rekonstrukcije, mogućnost rekonstrukcije bez potrebe za donorskim mjestom i laka prilagodba željenog volumena. Negativne strane rekonstrukcije implantatima su: komplikacije (BIA-ALCL, kapsularna kontrakcija...), rok trajanja implanata, veća invazivnost od lipofilinga i lošija rekonstrukcija kod dojki prethodno izloženih zračenju. Konačno, tkivni ekspander kao svoju prednost nudi postupno povećanje volumena dojke što umanjuje komplikacije implantata poput striae densatae, povećava kompatibilnost implantata sa zračenjem-izloženim dojkama i prilagodljivost veličine rekonstruirane dojke. Mane tkivnog ekspandera uključuju produljeni proces rekonstrukcije i povećan rizik od infekcije. Od hibridnih metoda rekonstrukcije dojke razlikujemo rekonstrukciju
s implantatima i lipofilingom, implantatima i režnjevima, tkivnim ekspanderom i lipofilingom, režnjevima i lipofilingom te rostrukom kombinacijom tkivnog ekspandera, implanatata i lipofilinga. |
| Abstract (english) | Hybrid breast reconstruction is a procedure that utilizes more than one reconstructive method in an attempt to achieve the anatomical appearance of the breast which is significantly deformed. It aims to maximize the advantages of each method while simultaneously covering the drawbacks of individually applied methods. Lipofilling, as one of its benefits, offers lesser invasiveness, a more natural look of the reconstructed breast, and the simultaneous possibility of gaining volume in the breast while reducing volume in areas where excess fat is undesirable. On the other hand, the negatives of lipofilling include: the potential need for multiple corrective treatments (each representing an additional risk for the patient), possible necrosis of transferred fatty tissue, and the inability to harvest fatty tissue in patients with a deficiency thereof. Implants, as their advantages, include the possibility of reconstruction in a single procedure, easily predictable reconstruction results, the ability to reconstruct without the need for a donor site, and easy adjustment of the desired volume. The downsides of reconstruction with implants include complications (BIA-ALCL, capsular contraction...), the lifespan of the implants, greater
invasiveness compared to lipofilling, and poorer reconstruction in breasts previously exposed to radiation. Finally, the tissue expander, as its advantage, offers a gradual increase in breast volume, reducing implant-related complications such as striae distensae, increasing compatibility of implants with radiation-exposed breasts, and adaptability of the reconstructed breast size. The downsides of the tissue expander include a prolonged reconstruction process and an increased risk of infection. Among the hybrid breast reconstruction methods, distinctions are made between reconstruction with implants and lipofilling, implants and flaps, tissue expander and lipofilling, flaps and lipofilling as well as the triple combination of tissue expander, implants, and lipofilling. |
