Spear Scott L, Boehmler James H, Clemens Mark W
Department of Plastic Surgery, Georgetown University Hospital, Washington, DC 20007, USA.
Plast Reconstr Surg. 2006 Dec;118(7 Suppl):136S-147S; discussion 148S-149S, 150S-151S. doi: 10.1097/01.prs.0000247311.12506.d7.
Augmentation/mastopexy is of considerable interest to plastic surgeons who perform breast surgery because of its complexity as well as its high rate of legal claims.
This single-surgeon, 3-year study evaluated complications, outcomes, and reoperation rates among 166 patients who underwent 171 procedures for primary and secondary augmentation and primary and secondary augmentation/mastopexy. Aspects of the treatment plan were reviewed, including classification of ptosis, procedure selection, surgical planning, and operative technique. There were 57 primary breast augmentations, 60 secondary breast augmentations, 17 primary mastopexies, eight secondary mastopexies, 23 primary augmentation/mastopexies, and 30 secondary augmentation/mastopexies.
The 23 primary and 30 secondary augmentation/mastopexy patients had 17 percent and 23 percent complication rates, respectively. The revision rate for augmentation mastopexy was 8.7 percent for the primary group and 16.6 percent for the secondary group. For reference, primary augmentation and secondary augmentation had complication rates of 1.7 percent and 21.6 percent, respectively. Primary augmentation had a 1.7 percent revision rate compared with 18.7 percent for secondary augmentation. The authors reviewed the most common problems leading to a revision, which were capsular contracture and asymmetry correction. Other complications included size change and rupture.
Primary augmentation/mastopexy is a commonly performed procedure and has a significantly higher complication rate than primary augmentation. Secondary augmentation/mastopexy is also common and has higher revision and complication rates.
隆胸/乳房固定术因其复杂性以及高法律索赔率,备受进行乳房手术的整形外科医生关注。
这项由单一外科医生开展的为期3年的研究,评估了166例患者接受的171次初次和二次隆胸手术以及初次和二次隆胸/乳房固定术的并发症、手术效果和再次手术率。对治疗方案的各个方面进行了回顾,包括乳房下垂的分类、手术选择、手术规划和手术技术。其中有57例初次隆胸、60例二次隆胸、17例初次乳房固定术、8例二次乳房固定术、23例初次隆胸/乳房固定术和30例二次隆胸/乳房固定术。
23例初次和30例二次隆胸/乳房固定术患者的并发症发生率分别为17%和23%。初次隆胸/乳房固定术组的修复率为8.7%,二次隆胸/乳房固定术组为16.6%。作为参考,初次隆胸和二次隆胸的并发症发生率分别为1.7%和21.6%。初次隆胸的修复率为1.7%,而二次隆胸为18.7%。作者回顾了导致修复的最常见问题,即包膜挛缩和不对称矫正。其他并发症包括尺寸变化和破裂。
初次隆胸/乳房固定术是一种常见的手术,其并发症发生率显著高于初次隆胸。二次隆胸/乳房固定术也很常见,且修复率和并发症发生率更高。