Department of Plastic Surgery, University of Perugia, Perugia, Italy.
J Plast Reconstr Aesthet Surg. 2012 Mar;65(3):312-9. doi: 10.1016/j.bjps.2011.08.047. Epub 2011 Oct 10.
BACKGROUND: Small-volume breast asymmetry is a challenging problem. In 2008, an intra-operative volume-adjustable breast implant, consisting of a round textured implant with an outer chamber filled with cohesive silicone gel and inner chamber filled with varying amounts of saline solution was marketed in Europe. We describe our experience in the correction of hypoplastic breasts with small-volume asymmetry using this device. METHODS: From May 2008 on, female patients presenting small-volume breast asymmetry were enrolled in the study. Standard pictures were taken before surgery and during follow-up visits over 1 year; standardised objective measurements of breast and chest were also taken. Statistical significance of value variation was assessed by Wilcoxon's rank sum test. A Visual Analogue Scale (VAS) was used to evaluate patients' and external physicians' judgement of breast symmetry achievement at the end of follow-up. The development of capsular contracture was assessed by measuring mammary compliance. RESULTS: A total of 38 females were treated. The implant pocket was subglandular in 14 cases, subpectoral in 14 and dual plane in 10. The adjustable implant was positioned in the smaller breast. A textured round implant, whose diameter was the same as the adjustable one, was positioned in the contralateral breast. Thirty-five patients were fully satisfied; three were partially satisfied. Good aesthetic and functional breast symmetry results were achieved in all patients, as demonstrated by the objective measurement statistical analysis. We observed one case of delayed wound healing, one of bleeding and one of seroma, with no major late complications. Baker's classification grade III capsular contracture was detected in one patient. Both implants maintained their initial volume. CONCLUSIONS: The possibility of intra-operatively modifying implant volume according to breast volume differences provides a reliable corrective option for hypoplastic breasts with small-volume asymmetry. Although these results are encouraging, a longer follow-up is required to evaluate implant ageing and long-term outcome.
背景：小体积乳房不对称是一个具有挑战性的问题。2008 年，一种术中可调节体积的乳房植入物在欧洲上市，该植入物由一个圆形纹理植入物组成，外部腔室充满粘性硅凝胶，内部腔室充满不同量的生理盐水。我们描述了使用该装置矫正小体积不对称的发育不良乳房的经验。
方法：自 2008 年 5 月起，招募出现小体积乳房不对称的女性患者参加研究。手术前和随访 1 年期间拍摄标准照片；还对乳房和胸部进行了标准的客观测量。通过 Wilcoxon 秩和检验评估数值变化的统计学意义。使用视觉模拟量表（VAS）评估患者和外部医生在随访结束时对乳房对称性实现的判断。通过测量乳房顺应性来评估包膜挛缩的发展。
结果：共治疗 38 例女性。14 例植入物位于胸大肌下，14 例位于胸肌下，10 例位于双平面。可调节植入物位于较小的乳房中。将一个与可调节植入物直径相同的圆形纹理植入物放置在对侧乳房中。35 例患者完全满意，3 例部分满意。客观测量的统计分析显示，所有患者均获得良好的美学和功能乳房对称性结果。我们观察到 1 例伤口愈合延迟，1 例出血和 1 例血清肿，但无重大晚期并发症。1 例患者发现贝克 III 级包膜挛缩。两个植入物均保持初始体积。
结论：根据乳房体积差异术中调节植入物体积的可能性为小体积不对称的发育不良乳房提供了一种可靠的矫正选择。尽管这些结果令人鼓舞，但需要更长的随访时间来评估植入物老化和长期结果。
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