Sohn B K, Chung Y J, Kim G, Yoon W J
Dankook University School of Medicine, Department of Plastic Reconstructive Surgery, Cheonan City, Korea.
Aesthetic Plast Surg. 2000 Nov-Dec;24(6):455-60. doi: 10.1007/s002660010077.
Augmentation mammoplasty can be approached by various methods according to the type of implant and implantation site depending on the status of the patient or surgeon's preference. The advantage for submuscular placement is based on problems associated with subglandular placement, especially capsular contracture and sensory changes in the nipple, and interference with the interpretation of mammograms is avoided. There are fewer complications such as hematoma, infection, and extrusion of the implant with submuscular dissection and relatively avascular, minimal sensory changes in the nipple compared with subglandular approach. The submuscular periareolar approach to augmentation mammoplasty was first described in the 1970s. This approach provides easy access to both the subglandular and subpectoral planes. It also provides a central point of access for creation of the implant pocket, which allows for easier and more accurate dissection in all diameters. The resultant periareolar scar is usually minimal with less injury to breast parenchyme and eventual biopsy or mastectomy incision to be performed through or around the areola. During the period of March 1999 to January 2000, 19 cases of who received submuscular periareolar augmentation mammoplasty under general anesthesia resulted in favorable scars with accurate access to pocket margin, easier dissection, and less bleeding compared with submuscular transaxillary augmentation mammoplasty. In our experience with the submuscular periareolar approach to breast augmentation it was highly versatile, safe, and less painful; postoperative hematoma incidence was greatly reduced and breast tissue injury was minimized.
根据植入物的类型和植入部位，可采用多种方法进行隆乳术，具体取决于患者的情况或外科医生的偏好。肌下植入的优势基于与腺下植入相关的问题，尤其是包膜挛缩和乳头感觉变化，并且避免了对乳房X线照片解读的干扰。与腺下入路相比，肌下剥离时血肿、感染和植入物挤出等并发症较少，且相对无血管，乳头感觉变化最小。乳晕下肌下入路隆乳术最早在20世纪70年代被描述。这种入路便于进入腺下和胸大肌下平面。它还为创建植入腔隙提供了一个中心入口点，这使得在各个直径方向上更容易、更精确地进行剥离。由此产生的乳晕瘢痕通常最小，对乳腺实质的损伤较小，最终的活检或乳房切除术切口可通过乳晕或在乳晕周围进行。在1999年3月至2000年1月期间，19例在全身麻醉下接受乳晕下肌下隆乳术的患者，与经腋窝肌下隆乳术相比，瘢痕良好，能准确进入腔隙边缘，剥离更容易，出血更少。根据我们对乳晕下肌下入路隆乳术的经验，它具有高度的通用性、安全性，疼痛较轻；术后血肿发生率大大降低，乳腺组织损伤最小化。
