Goethe Medical School, Frankfurt, Germany.
Aesthet Surg J. 2011 Sep;31(7):781-801. doi: 10.1177/1090820X11416936.
Transaxillary subpectoral augmentation mammaplasty (TASPA) is not widely accepted due to perceived limitations in pocket access, visualization, control, and subsequent risk for postoperative complications. Current published data do little to substantiate or refute those claims.
A retrospective chart review of a single surgeon's 20-year experience with the TASPA technique was undertaken to assess the incidence of total secondary procedures, implant-related revisions, and reoperations unrelated to the implant.
The senior author (DCM) performed 1776 primary TASPA procedures from January 1989 through December 2008. Of those, 94 patients did not meet inclusion criteria, leaving a total of 1682 records for analysis. Data reviewed included age, date of surgery, race, implant size and type, manufacturer, and reasons for reoperation.
Average age was 32.7 ± 8.1 years (range, 16-62). Average implant size was 438.5 ± 51.5 cc (range, 270-630). Implants from Allergan/Inamed/McGhan (Irvine, CA), Dow-Corning (Midland, MI), Mentor (Santa Barbara, CA), and Surgitek (Racine, PA) were inserted (n = 2094 saline, n = 1270 silicone). Mean follow-up time was 37.9 ± 45.4 months (range, one month to 19.8 years). Excluding staged mastopexies and treatment for breast cancer, total secondary procedures were required in 225 patients (13.4%). Implant-related revisions included malposition (2.97%), size change (2.5%), and capsular contracture (1.9%). Perioperatively, no infections occurred, and two patients (0.12%) experienced hematoma. Most reoperations (62.8%) were performed through the axilla. Comparison to published data showed an equal or lower rate of capsular contracture, hematoma, and infection with the TASPA approach.
Given its advantages of an inconspicuous scar, decreased infection, and decreased capsular contracture, TASPA can be safely offered to patients as an option in breast augmentation.
由于对口袋通道、可视化、控制以及随后的术后并发症风险的认知限制，经腋窝下胸肌下乳房增大成形术（TASPA）并未得到广泛接受。目前发表的数据几乎无法证实或反驳这些说法。
对一位外科医生 20 年 TASPA 技术经验进行回顾性图表审查，以评估总二次手术、与植入物相关的修订以及与植入物无关的再手术的发生率。
资深作者（DCM）于 1989 年 1 月至 2008 年 12 月进行了 1776 例 TASPA 主要手术。其中，94 例不符合纳入标准，因此共有 1682 例记录用于分析。审查的数据包括年龄、手术日期、种族、植入物大小和类型、制造商以及再手术的原因。
平均年龄为 32.7 ± 8.1 岁（范围为 16-62 岁）。平均植入物大小为 438.5 ± 51.5 cc（范围为 270-630 cc）。Allergan/Inamed/McGhan（加利福尼亚州欧文）、Dow-Corning（密歇根州米德兰）、Mentor（加利福尼亚州圣巴巴拉）和 Surgitek（威斯康星州拉辛）的植入物（n = 2094 盐水，n = 1270 硅胶）被插入。平均随访时间为 37.9 ± 45.4 个月（范围为一个月至 19.8 年）。不包括分期乳房提升术和乳腺癌治疗，225 例患者（13.4%）需要进行二次手术。与植入物相关的修订包括位置不当（2.97%）、大小变化（2.5%）和包膜挛缩（1.9%）。手术期间未发生感染，有 2 例患者（0.12%）发生血肿。大多数再手术（62.8%）通过腋窝进行。与已发表的数据相比，TASPA 方法的包膜挛缩、血肿和感染率相等或更低。
鉴于 TASPA 具有隐蔽性疤痕、降低感染和降低包膜挛缩的优势，可以将其作为乳房增大术的选择安全地提供给患者。
