Pitanguy Ivo, Vaena Michel, Radwanski Henrique N, Nunes Daniel, Vargas André F
Department of Plastic Surgery, Pontifical Catholic University of Rio de Janeiro, The Carlos Chagas Institute of Postgraduate Medical Studies, and The Ivo Pitanguy Institute, Rio de Janeiro, Brazil.
Aesthetic Plast Surg. 2007 May-Jun;31(3):238-43. doi: 10.1007/s00266-006-0173-x.
Recent studies have provided diverging results regarding the factors that may affect sensibility after primary breast augmentation. Implant volume is believed to be an important factor, but the relation of implant size to breast volume has not been adequately addressed. In addition, the literature shows that a conflict exists when the periareolar and inframammary approaches are compared. This study aimed to refine the volumetric analysis comparing the implant and final breast size as well as the intrinsic association of these two factors with postoperative sensory alteration of the breast.
A prospective study investigated patients who underwent aesthetic breast augmentation between June 2004 and October 2005 (i.e., a 16-month period) at the Ivo Pitanguy Institute. The sensibility in nine regions of the breast was tested before and after surgery using Semmes-Weinstein monofilaments. Breast sizers were used to compare the pre- and postoperative breast volumes. Statistical analysis of the data took into consideration the relative volume of the implant, the surgical approach, the presence of minor complications, the breast-feeding history, and the subjective evaluation of sensory changes in the patients.
A total of 37 patients who underwent breast augmentation were examined preoperatively. The relative volume of the implant was found to be associated with sensibility alterations. No difference was found between the periareolar and inframammary incision approaches. Other factors such as previous breast-feeding, minor complications, and subjective alterations were not associated with sensory alterations.
The study findings suggest that larger implants and smaller breasts show an increased association with postoperative sensory alterations of the breast. Plastic surgeons and their patients should be aware of this possibility. Implant volume should be considered together with breast size to avoid sensory complications, and this is summarized in the concept of relative volume.
近期研究对于初次隆乳术后可能影响感觉功能的因素给出了不一致的结果。植入体容积被认为是一个重要因素,但植入体大小与乳房容积之间的关系尚未得到充分探讨。此外,文献表明,在比较乳晕周围切口和乳房下皱襞切口时存在争议。本研究旨在完善容积分析,比较植入体与最终乳房大小,以及这两个因素与乳房术后感觉改变的内在关联。
一项前瞻性研究调查了2004年6月至2005年10月(即16个月期间)在伊沃·皮坦盖伊研究所接受美容隆乳手术的患者。使用Semmes-Weinstein单丝在手术前后测试乳房九个区域的感觉功能。使用乳房测量器比较手术前后的乳房容积。对数据的统计分析考虑了植入体的相对容积、手术方式、轻微并发症的存在、哺乳史以及患者对感觉变化的主观评估。
共有37例接受隆乳手术的患者接受了术前检查。发现植入体的相对容积与感觉改变有关。乳晕周围切口和乳房下皱襞切口之间未发现差异。其他因素,如既往哺乳史、轻微并发症和主观改变,与感觉改变无关。
研究结果表明,更大的植入体和更小的乳房与乳房术后感觉改变的关联增加。整形外科医生及其患者应意识到这种可能性。应将植入体容积与乳房大小一并考虑,以避免感觉并发症,这在相对容积的概念中得到了总结。