tetas1Comenzará a emplearse en la Argentina, es una técnica ambulatoria y demora sólo dos horas


Se presentó por primera vez en la Argentina una revolucionaria técnica de última generación que permite reconstruir y/o agrandar una mama mediante la transferencia de tejido graso autólogo (propio) y células madre, es decir, sin necesidad de prótesis.

Este sistema se utiliza principalmente en pacientes que fueron sometidas mastectomía o la llamada «cirugía conservadora», que es aquella en la que se extrae sólo parte de la mama; aunque también puede emplearse en mujeres que tienen complicaciones post-implante mamario y en aquellas que desean un aumento de busto sin implantes, entre otras aplicaciones.

Durante un encuentro en el Hospital Alemán, el doctor Klaus Ueberreiter, jefe del Departamento de Cirugía Plástica de la Asklepios Klinik (Berlín, Alemania), presentó oficialmente este procedimiento, llamado Método BEAULI (Breast Augmentation by Lipotransfer) que él contribuyó a desarrollar. La técnica se utilizará en nuestro país inicialmente en centros médicos como el Hospital Alemán y el Hospital Británico de Buenos Aires, entre otros.

«La transferencia de grasa autóloga está aceptada generalmente como una opción quirúrgica para el aumento mamario», explicó Ueberreiter. «En marzo de 2007, Sydney Coleman publicó los resultados de un estudio sobre aumento de busto con grasa autóloga, y posteriormente otros autores, tales como Zocchi y Delay, de Italia y Francia, publicaron hallazgos similares». No obstante, los médicos no podían terminar de resolver favorablemente determinados obstáculos: algunos injertos no sobrevivían, los procedimientos podían llegar a durar entre seis y ocho horas, y la tasa de sobrevida del tejido era del 90 por ciento).

Hace unos pocos años se halló que el tejido graso abdominal es rico en células madre, lo cual, entre otras aplicaciones, permitiría que al injertar grasa que contiene células madre el resultado sea más eficaz y duradero. En base a tales hallazgos, la compañía alemana Human-Med ideó un dispositivo especial ‘asistido por agua’, denominado WAL (Water jet–assisted lipoplasty) para extraer tejido graso del abdomen y los muslos de la paciente conservando ‘viva’ a la grasa extraída y preservando las células madre que ésta contiene.

Está técnica cuenta con la aprobación de la FDA (Food and Drug Administration) de los Estados Unidos y de la CE (Europa), entre otras.

El doctor Francisco Gabriel Errea, jefe del Servicio de Cirugía Plástica del Hospital Británico de Buenos Aires, explicó: «Este sistema permite estandarizar el método y los resultados. Se realiza una disección hídrica: se infiltra líquido en el tejido adiposo, y la grasa se separa y se extrae sin que resulte dañada en el procedimiento. Luego es procesada mediante un filtro especial, para obtener tejido útil. Seguidamente, se inyecta el tejido graso vivo en la mama (no en la glándula mamaria), con resultados positivos a largo plazo».

En tanto el doctor Gustavo Prezzavento, jefe del Servicio de Cirugía Plástica y Reparadora del Hospital Alemán, comentó que «al hacer el injerto hay que utilizar células que van a sobrevivir. Este método no ‘rompe’ el tejido que se va a injertar, y permite transferir tanto células grasas maduras (adipocitos) como pre-adipocitos y células madre que pueden subsanar el tejido si un adipocito muere».

Ueberreiter confirmó que «las células injertadas quedan permanentemente en el tejido, y después de una seis semanas, el 80 por ciento de las células trasplantadas se encuentran integradas al tejido receptor». El científico remarcó que este procedimiento, de carácter ambulatorio, permite que el tejido graso sea extraído y transferido en una sola operación que dura unas dos horas. «La vitalidad y tasa de integración de las células grasas son muy buenas».

En una aplicación se pueden injertar hasta 200 ml de grasa, por lo que si el tamaño requerido fuera mayor serán necesarias más sesiones (las prótesis de siliconas estándar en nuestro país son más grandes y aumentaron en los últimos años, utilizándose actualmente las de 250 ml a 325 ml).

El doctor Abel Chajchir, médico especialista en Cirugía Plástica y Reparadora y pionero en transferencia de grasa, remarcó que «esta técnica es muy prometedora, pero de ninguna manera significa el fin de las prótesis mamarias. Es sin duda una importante solución, aunque existen restricciones, como por ejemplo en pacientes en pacientes con tejido adiposo insuficiente».

Sin embargo, agregó el doctor Manuel Viñal, jefe de la División de Cirugía Plástica del Hospital Ramos Mejía, «cada caso en particular debe ser analizado por el equipo tratante, integrado por un cirujano plástico, un patólogo mamario y un oncólogo, y en algunos casos específicos como son la radiodermitis o esclerodermia, hasta por un dermatólogo, siendo el grupo, en conjunto con el propio paciente, quien establecerá la técnica más conveniente para esa situación».

Algunas aplicaciones
• Reconstrucción mamaria en pacientes con cáncer sometidas a mastectomía y/o cirugía conservadora
• Corrección de complicaciones aparecidas tras un implante mamario
• Aumento mamario en mujeres que no desean implantes
• Corrección de diferentes defectos en otras partes del cuerpo

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