Somogyi Ron Barry, Stavrou Demetris, Southwick Graeme
Dr Somogyi was a Clinical Fellow at a private plastic surgery practice in Melbourne, Australia, at the time of this study and is now a plastic surgeon in private practice in Toronto, Canada. Dr Stavrou was a Clinical Fellow at a private plastic surgery practice in Melbourne, Australia, at the time of this study and is now a plastic surgeon in private practice in Cyprus, Greece. Dr Southwick is a plastic surgeon in private practice in Melbourne, Australia.
Aesthet Surg J. 2015 May;35(4):394-401. doi: 10.1093/asj/sju058.
Virtually all patients presenting for augmentation mammaplasty will exhibit some degree of asymmetry. The use of asymmetric implants to address small- volume breast asymmetry introduces uncontrolled variables into the longevity of postoperative results.
We described a novel method of addressing small-volume asymmetry using deep parenchymal resection (DPR) to achieve symmetry prior to insertion of identical implants. We also compared our results with this technique to a cohort of standard augmentation mammaplasty patients.
All patients underwent 3-dimensional (3D) imaging during consultation. In patients with small-volume breast asymmetry, a uniform disk of deep parenchymal tissue was resected from the base of the larger breast cone through an inframammary incision. A standard submuscular augmentation was then completed. Five patients (DPR group) with appreciable small-volume asymmetry underwent DPR in the larger breast prior to insertion of identical implants. Fifty-six consecutive patients with no appreciable volume asymmetry (standard group) underwent standard submuscular breast augmentation.
Using 3D imaging preoperatively, DPR-group patients had an estimated breast volume asymmetry of 86 ± 58 g and had 55 ± 27 g excised from the larger breast intraoperatively, allowing for insertion of identical implants in each patient. Complications in the standard group included 1 case of rippling and 2 cases of malposition. One case of malposition was noted in the DPR group. No other complications were recorded in either group over 6 months.
Our novel method of addressing small-volume breast asymmetry allows for the use of identical implants and presents no increase in early complications.
几乎所有前来进行隆乳术的患者都会表现出一定程度的不对称。使用不对称植入物来解决小体积乳房不对称问题会给术后效果的持久性引入不可控变量。
我们描述了一种新颖的方法，即在植入相同的植入物之前，通过深部实质切除术（DPR）来解决小体积不对称问题以实现对称。我们还将该技术的结果与一组标准隆乳术患者的结果进行了比较。
所有患者在咨询期间均接受了三维（3D）成像。对于小体积乳房不对称的患者，通过乳房下切口从较大乳房圆锥体的底部切除一块均匀的深部实质组织盘。然后完成标准的胸肌下隆乳术。五名存在明显小体积不对称的患者（DPR组）在植入相同的植入物之前在较大的乳房上进行了DPR。五十六名无明显体积不对称的连续患者（标准组）接受了标准的胸肌下隆乳术。
术前使用3D成像，DPR组患者估计的乳房体积不对称度为86±58克，术中从较大乳房切除了55±27克，从而使每位患者都能植入相同的植入物。标准组的并发症包括1例波纹和2例位置异常。DPR组有1例位置异常。两组在6个月内均未记录到其他并发症。
我们解决小体积乳房不对称问题的新颖方法允许使用相同的植入物，并且早期并发症没有增加。
