Cette nouvelle technique vient de recevoir son autorisation pour une application en chirurgie plastique et esthétique du sein. Le Dr Jean Masson, chirurgien plasticien à l’hôpital Saint-Louis à Paris, pratique cette lipostructure qui, selon lui, donne de bons résultats et offre de nombreux avantages. Voici ses explications.

 

Jean Masson

LMC : qu'est-ce que le lipofilling ? 

Le lipofilling ou greffe de cellules graisseuses autologues (provenant de son propre corps) est une technique récente permettant de corriger les pertes de volume au niveau de toutes les zones du corps. De la graisse prélevée de façon non traumatique, le plus souvent sous anesthésie générale, est centrifugée pendant une à deux minutes, avant d’être réinjectée dans les zones concernées.Depuis moins d’un an, cette technique est autorisée en France au niveau des seins et dans  un but esthétique. Le lipofilling permet dans certains cas d’éviter la mise en place d’une prothèse mammaire, tout en corrigeant les excès graisseux disgracieux au niveau de certaines zones du corps.

 

LMC : comment est née cette technique ?

Elle s’est surtout développée à partir de 1995 grâce à un chirurgien américain , le Dr Sidney Coleman, qui a utilisé des injections de graisse dans les zones post-traumatiques pour combler des séquelles cicatricielles, ainsi que pour rajeunir le visage ou le dos des mains.

Cette technique est actuellement largement utilisée dans tous les domaines de la chirurgie plastique et réparatrice mais aussi esthétique. L’amélioration de la technique, et du matériel utilisé permet d’obtenir de bons résultats de lipofilling ou lipostructure avec des protocoles de plus en plus fiables.

 

LMC : quelles différences avec les autres techniques existantes (DIEP, lambeau du grand dorsal...) ?

La technique du lipofilling est une technique simple, facilement reproductible, avec une hospitalisation le plus souvent réalisée en ambulatoire. Les cicatrices pour prélever la graisse sont cachées dans les plis et mesurent toujours moins d’un centimètre. Pour réinjecter cette graisse, les incisions sont encore plus petites et varient entre 2 et 3 millimètres à proximité de la zone à corriger. Le DIEP et le lambeau de grand dorsal sont des techniques chirurgicales bien plus lourdes, pouvant nécessiter 4 à 6 heures d’anesthésie générale et entre 4 et 8 jours d’hospitalisation. Les cicatrices de prélèvement de ces lambeaux sont beaucoup plus longues et peuvent être plus visibles, et ce de façon permanente. Mais les indications des prothèses en reconstruction mammaires et à visée esthétique gardent leur place pour les patientes présentant un sein généreux et sans zones donneuses de graisse. 

 

LMC : toute femme peut-elle y avoir recours ? 

Pour bénéficier de cette technique, les femmes doivent présenter un excès graisseux significatif permettant le comblement des zones souhaitées. Dans le cadre de la chirurgie esthétique du sein, il est actuellement recommandé de proposer le lipofilling pour toutes femmes de moins de 35 ans présentant une mammographie normale de moins d’un an. Dans le cadre de la chirurgie réparatrice après cancer du sein et radiothérapie, les séquelles volumétriques de la zone de tumorectomie peuvent bénéficier d’un lipofilling dans le cadre d’un protocole strict, actuellement réalisé dans plusieurs centres hospitaliers.

 

LMC : comment cela se passe-t-il pour la patiente ?

Lors de la consultation, un consentement éclairé est remis à la patiente expliquant la technique chirurgicale, avec le détail de ses avantages et inconvénients. La durée de l’intervention varie entre 30 minutes et 90 minutes en fonction de la quantité de graisse à prélever et à réinjecter. La graisse pouvant se résorber de façon variable (20à 30 %), une surcorrection de la graisse injectée est réalisée. Le nombre de séances chirurgicales est en général de deux séances, mais dans certains cas il est nécessaire de procéder à une séance supplémentaire.

 

LMC : quels sont donc les bénéfices de cette technique ? Ses inconvénients ?

Le lipofilling permet la correction de rondeurs corporelles, des cicatrices de prélèvement de graisse presque invisibles, et une opération en ambulatoire avec une anesthésie générale de faible importance voire, dans certains cas, la possibilité d’une anesthésie locale pure.

Les inconvénients sont la résorption partielle de la graisse injectée pouvant nécessiter 2 à 3 séances de lipofilling. Des douleurs peu importantes post-opératoires ainsi que de l’œdème, et des ecchymoses, sont habituelles mais nettement inférieures aux séquelles chirurgicales des lambeaux réalisés sous anesthésie générale. Grâce au lipofilling, les coques ou contractures capsulaires autour des prothèses - toujours imprévisibles avec le temps - sont totalement inexistantes.

 

Propos recueillis par Stéphanie Honoré

Commentaires : (6)

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Portrait de Unique_Féminine

La chirurgie permet aux femmes opérées du sein de se sentir mieux dans leurs corps, mais en attendant l'opération, on peut porter une prothèse mammaire externe .

Portrait de biscottedidi

Il y a 4 jours de cela, j'ai pratiqué cette methode sur mon sein droit.
Je vous tiendrais au courant pour la suite.

Portrait de cerOnac

Le chir m'a parlé de cette méthode dernièrement. Vu la graisse à prendre ailleurs, on peut faire d'une pierre deux coups ! Possible également de combler un creux axillaire suite à un curage. Faut voir... Déjà deux ou trois interventions sont nécessaires et après ? sur le plus long terme ? Comme tout, il faut du recul et pour ça des cobayes. Mais pourquoi pas... Moins lourd en tout cas que d'autres techniques effectivement.

cerOnac
"On ne voit bien qu'avec le cœur, l'essentiel est invisible avec les yeux"
"On peut construire quelque chose de beau avec les pierres du chemin"
"On a deux vies, la seconde commence quand on prend conscience qu'on en a qu'une"