Banff, Alberta, Canada From private practice.
Plast Reconstr Surg. 2011 Jan;127(1):56-66. doi: 10.1097/PRS.0b013e3181fad34d.
The problem of double capsules and late seromas is a relatively new phenomenon in breast augmentation surgery.
The author's experience with double capsules in 14 patients is outlined. The author reviewed all primary bilateral breast augmentations and primary bilateral mastopexy-augmentations after the moratorium in 1992. There were 209 patients with saline implants, 160 patients with CML and CMH Microcell textured surface implants, 105 patients with Biocell textured surface silicone gel breast implants, and 152 patients with smooth round silicone gel breast implants. Complications and revisions were reviewed to see if any patterns emerged.
Fourteen patients were found to have double capsules. Double capsules were only seen with the Biocell textured surface implant. Three patients developed late seromas (more than a year after their original surgery), with two patients requiring urgent drainage of an expanding seroma/hematoma. Seven patients were found to have double capsules as an incidental finding for procedures, such as asymmetry and bottoming out, and five patients were found to have double capsules when surgery was performed for capsular contracture. The review of complications and revisions showed that the silicone gel implants were far better than saline implants. Highly cohesive Microcell textured CMH and CML implants had by far the best capsular contracture profile. Biocell texturing increased the capsular contracture rate.
Double capsules and late seromas are a relatively new problem in breast augmentation surgery. The problem was not seen in smooth saline or smooth silicone gel breast implants but only in aggressively textured implants.
双包膜和迟发性血清肿是乳房增大手术中相对较新的问题。
作者概述了在 14 名患者中遇到的双包膜问题。作者回顾了 1992 年暂停后所有双侧原发性乳房增大和双侧乳房缩小增大的病例。其中盐水植入物患者 209 例，CML 和 CMH Microcell 纹理表面植入物患者 160 例，Biocell 纹理表面硅胶凝胶乳房植入物患者 105 例，光滑圆形硅胶凝胶乳房植入物患者 152 例。回顾并发症和修复情况，看是否有任何模式出现。
发现 14 名患者有双包膜。只有 Biocell 纹理表面植入物才会出现双包膜。3 名患者出现迟发性血清肿（在最初手术一年后），其中 2 名患者需要紧急引流扩大的血清肿/血肿。7 名患者因手术治疗不对称和底部塌陷等问题而偶然发现双包膜，5 名患者因包膜挛缩而行手术时发现双包膜。并发症和修复情况的回顾显示，硅胶凝胶植入物明显优于盐水植入物。高内聚性 Microcell 纹理 CMH 和 CML 植入物具有迄今为止最好的包膜挛缩特征。Biocell 纹理增加了包膜挛缩的发生率。
双包膜和迟发性血清肿是乳房增大手术中相对较新的问题。在光滑的盐水或光滑的硅胶凝胶乳房植入物中未发现该问题，但仅在积极纹理化的植入物中发现。
