Chasan Paul E, Francis Cameron S
University of California, San Diego, CA, USA.
Aesthet Surg J. 2008 Jan-Feb;28(1):63-9. doi: 10.1016/j.asj.2007.07.007.
Despite more than 3 million breast implant surgeries performed to date, the common sequela of implant malposition is a problem to which little attention has been paid in the literature. It can be treated predictably and relatively simply with capsulorrhaphy and mirror-image capsulotomy. Additionally, capsulorrhaphy can be used to reduce the size of the implant pocket when changing to a smaller implant.
Several capsulorrhaphy techniques have emerged that allow a more precise result with less effort. In almost all cases of implant malposition, a mirror-image capsulotomy was performed to decrease the tension on the capsulorrhaphy repair. Silicone gel-filled implants were placed in all cases.
Seventy-five patients underwent capsulorrhaphy for implant malposition or implant size reduction between May 2002 and March 2006. Of these patients, just under half (49%) had an accompanying mastopexy. Excision of capsular tissue and prolonged taping of the breasts were found not to be necessary. Average follow-up was 21 months; no complications were reported.
The current technique of capsulorrhaphy and mirror-image capsulotomy has demonstrated satisfactory improvement in implant malposition, without the need for excision of capsular tissue or prolonged taping. Patients did report that their postoperative discomfort was greater than anticipated.
尽管迄今为止已进行了超过300万例乳房植入手术，但植入物位置不当这一常见后遗症在文献中很少受到关注。通过囊缝合术和镜像囊切开术可以对其进行可预测且相对简单的治疗。此外，在更换为较小尺寸的植入物时，囊缝合术可用于减小植入腔隙的大小。
出现了几种囊缝合术技术，这些技术可以用更少的努力获得更精确的效果。在几乎所有植入物位置不当的病例中，均进行了镜像囊切开术以减轻囊缝合修复的张力。所有病例均植入了硅胶填充的植入物。
2002年5月至2006年3月期间，75例患者因植入物位置不当或减小植入物尺寸而接受了囊缝合术。在这些患者中，近一半（49%）同时进行了乳房固定术。发现无需切除包膜组织和长时间包扎乳房。平均随访21个月；未报告并发症。
目前的囊缝合术和镜像囊切开术技术已证明在改善植入物位置不当方面效果令人满意，无需切除包膜组织或长时间包扎。患者确实报告术后不适比预期更严重。
