Department of Plastic Surgery, College of Medicine, The Catholic University of Korea, 505 Ban Po Dong, Seocho-gu, Seoul, 137-040, Korea.
Aesthetic Plast Surg. 2012 Feb;36(1):115-21. doi: 10.1007/s00266-011-9761-5. Epub 2011 Jun 4.
Among thin patients, upper pole skin of less than 2 cm on a pinch test is an indication for submuscular implant placement. However, rippling, palpability, and visibility of the implant are frequently observed in the lower and lateral aspects of the breast due to the lack of muscle coverage in the area. To overcome these problems, a subpectoral-subfascial breast augmentation was performed including subfascial dissection of the rectus abdominis, external abdominal oblique muscle, and serratus anterior muscle as one sheet to cover the inferolateral aspect of the implant.
From March 2008 to March 2010, 62 thin patients with hypomastia underwent subpectoral-subfascial breast augmentation. For all these patients, the result of the pinch test was less than 2 cm on the upper pole of the breast and less than 1 cm on the lower and lateral aspect. With a transareolar-perinipple incision, pockets were created such that the superomedial portion was covered by the pectoralis major muscle, and the inferolateral portion was covered by the fascial flap of neighboring muscles.
The results were satisfactory, reproducible, and predictable. The implants were not palpable or visible during a mean follow-up period of 19 months due to the inclusion of a fascial flap in all the patients.
This technique, which uses the advantages of both subpectoral and subfascial techniques, can offer a high-grade result. Especially for thin patients with less subcutaneous tissue, it provides excellent upper and lower pole coverage and gives the shape of the breast a natural appearance, with no palpability or rippling.
在消瘦患者中，捏皮试验时上极皮肤小于 2cm 是放置胸肌下假体的指征。然而，由于该区域缺乏肌肉覆盖，假体的下部和外侧常出现波纹、可触及和可见。为了克服这些问题，进行了胸肌下-筋膜下乳房增大术，包括将腹直肌、腹外斜肌和前锯肌的筋膜下部分作为一个整体进行解剖，以覆盖假体的下外侧。
2008 年 3 月至 2010 年 3 月，62 例消瘦型乳房发育不良患者接受了胸肌下-筋膜下乳房增大术。所有这些患者的捏皮试验结果均为乳房上极小于 2cm，下极和外侧小于 1cm。通过乳晕切口，形成口袋，使上部由胸大肌覆盖，下部和外侧由相邻肌肉的筋膜瓣覆盖。
结果满意、可重复、可预测。由于所有患者均包含筋膜瓣，因此在平均随访 19 个月期间，假体不可触及或可见。
该技术结合了胸肌下和筋膜下技术的优点，可以提供高质量的结果。特别是对于皮下组织较少的消瘦患者，它可以提供极好的上极和下极覆盖，并使乳房的形状呈现自然外观，无触感或波纹。
