Department of Plastic Surgery, Loma Linda University Medical Center, Loma Linda, CA 92354, USA.
Aesthet Surg J. 2009 Nov-Dec;29(6):485-93. doi: 10.1016/j.asj.2009.09.007.
Revisionary augmentation and revision of augmentation mastopexy are of considerable interest to plastic surgeons who perform breast surgery because of the procedures' complexity. In these cases, surgeons are faced with either thinned breast tissues resulting from large breast implants with tissue stretch or encapsulation caused by excessive scarring. To our knowledge, there are currently no large-series studies describing the use of acellular dermal matrices (ADM) in cosmetic breast surgery.
The authors describe the use of the ADM in revisionary breast surgery to establish the aesthetic breast form.
A retrospective chart review was conducted of 78 consecutive patients who underwent revisionary breast augmentation and augmentation mastopexies with ADM during a period of just over two years (October 2005 to January 2008). Data collected included patient characteristics, complications, outcomes, and reoperation rates.
Seventy-eight procedures were performed with ADM during the two-year period, with a minimum of 12 months of follow-up. There were two complications requiring reoperations for a hematoma and implant malposition, respectively. There were no Baker III or IV capsular contractures at one year postprocedure.
Revisionary augmentation and revision of augmentation mastopexy are commonly performed procedures and they have a significantly higher complication rate than primary procedures. This series shows that the ADM can be used both safely and effectively in revisionary cases, resulting in decreased rates of capsular contracture and implant cushioning/stabilization.
由于手术的复杂性，为乳房手术的整形医生对乳房增大修复术和乳房增大提升术的修订版本很感兴趣。在这些情况下，外科医生面临的问题是由于大乳房植入物导致的组织拉伸或过度瘢痕形成而导致的乳房组织变薄。据我们所知，目前尚无大型系列研究描述在美容乳房手术中使用去细胞真皮基质（ADM）。
作者描述了在修复性乳房手术中使用 ADM 来建立美容乳房形态的方法。
对 78 例连续患者进行了回顾性图表审查，这些患者在两年多的时间内（2005 年 10 月至 2008 年 1 月）接受了 ADM 修复性乳房增大和乳房增大提升术。收集的数据包括患者特征、并发症、结果和再次手术率。
在两年期间共进行了 78 例 ADM 手术，至少随访了 12 个月。有两个并发症需要再次手术，分别是血肿和植入物位置不正。术后一年没有 Baker III 或 IV 级包膜挛缩。
修复性乳房增大和乳房增大提升术是常见的手术，其并发症发生率明显高于初次手术。本系列研究表明，ADM 可安全有效地用于修复病例，降低包膜挛缩和植入物缓冲/稳定的发生率。
