Washington, D.C. From he Department of Plastic Surgery, Georgetown University.
Plast Reconstr Surg. 2014 Jul;134(1 Suppl):28S-37S. doi: 10.1097/PRS.0000000000000351.
With the recent availability of shaped silicone gel implants for breast reconstruction, many plastic surgeons are inquiring as to when and how these devices should be used. Questions about indications, algorithms, and techniques have become prevalent. This article reviews the author's experience using Sientra's highly cohesive shaped silicone gel devices for breast reconstruction.
A total of 31 patients had prosthetic breast reconstruction procedures using Sientra's shaped silicone gel implants. Bilateral reconstruction was performed in 16 women; thus, a total of 47 breasts were reconstructed or revised. Sientra's 3 shaped implants included the classic-base, round-base, and oval-base devices. Reconstructions occurred immediately following mastectomy, on a delayed basis following mastectomy, and for revisional purposes following a previous reconstruction using a nonshaped device. Mean follow-up for the 31 patients was 7.9 months.
There were a total of 3 complications that occurred in 3 patients (9.6%) and in 3 breasts (6.4%). These included an infection in 2 breasts (4.3%) and device exposure due to incisional dehiscence in 1 breast (2.1%). No patient developed a grade 3 or 4 capsular contracture, seroma, or device malposition/rotation. Reoperation was necessary in 3 of 31 women (9.7%).
Sientra's highly cohesive shaped silicone gel breast implant has been useful for controlling breast shape, contour, and position for breast reconstruction or revision following mastectomy. Breast projection has been maintained, and malrotation has not been observed within the follow-up period. Adverse events have been few, and patients have been pleased with the surgical outcomes.
随着最近可用于乳房重建的成型硅胶凝胶植入物的出现，许多整形外科医生都在询问何时以及如何使用这些设备。关于适应证、算法和技术的问题已经很普遍。本文回顾了作者使用 Sientra 的高凝聚力成型硅胶凝胶设备进行乳房重建的经验。
共有 31 名患者接受了 Sientra 的成型硅胶凝胶植入物的假体乳房重建手术。16 名女性进行了双侧重建，因此总共重建或修复了 47 个乳房。Sientra 的 3 种成型植入物包括经典基底、圆形基底和椭圆形基底装置。重建是在乳房切除术后即刻进行，在乳房切除术后延迟进行，以及为了修改先前使用非成型装置进行的重建而进行。31 名患者的平均随访时间为 7.9 个月。
共有 3 名患者（9.6%）和 3 个乳房（6.4%）发生了 3 种并发症。其中包括 2 个乳房（4.3%）的感染和 1 个乳房（2.1%）因切口裂开导致的器械暴露。没有患者发生 3 级或 4 级包膜挛缩、血清肿或器械位置/旋转不良。31 名女性中有 3 名（9.7%）需要再次手术。
Sientra 的高凝聚力成型硅胶凝胶乳房植入物对于控制乳房形状、轮廓和位置，用于乳房切除术后的重建或修改非常有用。乳房突出得到了保持，并且在随访期间没有观察到旋转不良。不良事件很少，患者对手术结果满意。
