Madrid, Spain; and Houston, Texas From the Plastic, Reconstructive, and Aesthetic Surgery Service, Hospital Quirón; and Baylor College of Medicine.
Plast Reconstr Surg. 2013 Jun;131(6):1404-1412. doi: 10.1097/PRS.0b013e31828bd65b.
Selecting the appropriate implant is one of the most important and demanding decisions in breast augmentation with anatomical implants, because different widths, heights, and projections can be found for a given volume. Most of the related literature and surgeons' concern have focused on width and projection. Implant height selection, however, has remained deeply overlooked, and it has been assumed that it depended on the suprasternal notch-to-nipple distance and, to a large extent, on the patient's height.
With more than 5123 breast augmentations performed over the past 15 years, the authors performed an analysis of the breast and implant height with consequences in aesthetic augmentation of the breast. Two concepts--breast implantation base (or breast footprint) and somatotype--were explored. Their influence in the selection of the appropriate anatomical implant height is investigated.
Selection of implant height should follow the patient's breast implantation base, which is highly influenced by her somatotype. With this assumption, a "number Y" is proposed that correlates the suprasternal notch-to-nipple distance with the thoracic perimeter and unveils the shape of the breast implantation base in the particular patient.
Adjusting the implant shape/footprint to the breast implantation base/breast footprint gives the surgeon control over the upper pole of the breast and allows a predictable postoperative result. The number Y rationalizes the selection of the implant height in breast augmentation.
CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, IV.
在解剖型假体隆乳术中，选择合适的假体是最重要且最具挑战性的决策之一，因为对于给定的体积，可以找到不同的宽度、高度和突度。相关文献和大多数外科医生的关注焦点主要集中在宽度和突度上。然而，假体高度的选择却被严重忽视，人们普遍认为它取决于胸骨上切迹到乳头的距离，在很大程度上还取决于患者的身高。
作者在过去 15 年中进行了超过 5123 例乳房增大手术，对乳房和假体高度进行了分析，这些分析对乳房美学增大有重要意义。探讨了两个概念——乳房植入基底（或乳房足迹）和体型——并研究了它们对选择合适解剖型假体高度的影响。
假体高度的选择应遵循患者的乳房植入基底，而乳房植入基底受体型的影响较大。基于这一假设，提出了一个“Y 数”，它将胸骨上切迹到乳头的距离与胸周径相关联，并揭示了特定患者乳房植入基底的形状。
调整假体形状/足迹以适应乳房植入基底/乳房足迹，使外科医生能够控制乳房的上极，并实现可预测的术后效果。Y 数使假体高度在隆乳术中的选择合理化。
临床问题/证据水平：治疗，IV 级。
