Forcada Eduardo Melero, Fernández Miguel Calderón, Aso Jorge Vizán, Iglesias Israel Pena
Private Practice, Av Reina Victoria Nº17, 7ºa, 28003, Madrid, Spain,
Aesthetic Plast Surg. 2014 Aug;38(4):711-7. doi: 10.1007/s00266-014-0356-9. Epub 2014 Jun 18.
A single-stage operation to correct ptotic and hypoplastic breasts would appear to be a very appealing option for both surgeons and patients. However, this procedure is the most often litigated in aesthetic surgery because of its frequent complications. Our goal in this article is to report our experience with a four-flap technique for implant coverage in maximum reduction mastopexy with prosthesis.
From January 2011 to March 2013, a total of 41 patients with Regnault grade II or grade III ptosis with no hypertrophy underwent primary bilateral augmentation mastopexy. Our technique includes an inverted-T mastopexy and a thin, well-vascularized, inferior dermoglandular flap to cover the inferior pole of the implant. Retrospective data collection revealed a mean patient age of 37.5 years. Thirty-nine patients were treated with round cohesive silicone gel implants and two with anatomical cohesive gel implants. The mean implant volume was 280 cc and mean follow-up time was 14 months.
The following complications were observed in declining frequency: four suture dehiscences, two hematomas, one capsular contracture, one implant malposition, and one poor scarring. A satisfaction questionnaire revealed very high satisfaction in 23 patients (56.09 %), high satisfaction in 12 (29.26 %), moderate satisfaction in four (9.75 %), and low satisfaction in two (4.87 %).
Our results demonstrated a low complication rate (21.9 %) and low reoperation rate (12.1 %) with our technique and make us confident in recommending this technique for grade II and grade III ptosis.
This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors at www.springer.com/00266 .
对于外科医生和患者而言，一期手术矫正乳房下垂和发育不全似乎是一个非常有吸引力的选择。然而，由于该手术并发症频发，它是美容手术中最常引发诉讼的。本文的目的是报告我们在采用四皮瓣技术进行假体植入最大程度乳房缩小上提术中覆盖假体的经验。
2011年1月至2013年3月，共有41例Regnault II级或III级下垂且无肥大的患者接受了一期双侧隆乳上提术。我们的技术包括倒T形乳房上提术和一块薄的、血运良好的下皮腺瓣以覆盖假体的下极。回顾性数据收集显示患者平均年龄为37.5岁。39例患者使用圆形粘性硅胶假体，2例使用解剖型粘性凝胶假体。平均假体体积为280 cc，平均随访时间为14个月。
观察到的并发症按发生频率递减依次为：4例缝线裂开、2例血肿、1例包膜挛缩、1例假体移位和1例瘢痕不佳。一份满意度调查问卷显示，23例患者（56.09%）非常满意，12例（29.26%）满意，4例（9.75%）中度满意，2例（4.87%）不满意。
我们的结果表明，我们的技术并发症发生率低（21.9%），再次手术率低（12.1%），这使我们有信心推荐该技术用于II级和III级下垂。
证据等级V：本刊要求作者为每篇文章指定证据等级。有关这些循证医学评级的完整描述，请参阅目录或www.springer.com/00266上的作者在线指南。
