Moliver Clayton L, Sanchez Erick R, Kaltwasser Kyle, Sanchez Ruston J
Dr Moliver is a Clinical Professor of Plastic Surgery, Dr E. Sanchez is a Resident, and Mr Kaltwasser is a Medical Student, Department of Surgery, Division of Plastic Surgery, University of Texas Medical Branch, Galveston, Texas. Dr R. Sanchez is a Resident, Department of Surgery, Division of Plastic Surgery, University of Wisconsin Hospital and Clinics, Madison, Wisconsin.
Aesthet Surg J. 2015 Sep;35(7):NP203-10. doi: 10.1093/asj/sjv072. Epub 2015 Jun 23.
Implant malposition is becoming an increasingly recognized complication following subpectoral breast augmentation. Although several causes of medial malposition have been previously demonstrated, medial implant malposition secondary to unintended pectoralis muscle slips has not been previously described.
The goal of this study is to describe a form of medial implant malposition caused by pectoralis major and minor musculature vectors on the implant.
The primary investigator performed a retrospective review of all patients who underwent revisional breast surgery for the diagnosis of symmastia or medial implant malposition following subpectoral augmentation. Those patients with muscular-type etiology for medial implant malposition were identified.
Five patients with pectoralis muscle slips causing medial implant malposition were identified. The pectoralis muscle slips were successfully diagnosed on preoperative exam and corrected with specific surgical procedures aimed at balancing surrounding forces and thus correcting malposition.
Pectoralis muscle slips contributing to medial malposition can be found in some patients after subpectoral breast augmentation. The etiology of this deformity is unknown, but theorized to be caused by anatomic predisposition, with slips inadvertently formed during subpectoral pocket formation arising from the pectoralis minor and/or incompletely released or accessory pectoralis major muscles.
植入物位置不当正日益成为胸肌下隆乳术后一种被更多认识到的并发症。尽管先前已证实了几种导致内侧位置不当的原因，但由意外的胸肌滑脱引起的内侧植入物位置不当此前尚未见报道。
本研究的目的是描述一种由胸大肌和胸小肌对植入物的作用力导致的内侧植入物位置不当形式。
第一作者对所有因胸肌下隆乳术后诊断为胸骨前凸或内侧植入物位置不当而接受乳房修复手术的患者进行了回顾性研究。确定那些内侧植入物位置不当病因是肌肉类型的患者。
确定了5例因胸肌滑脱导致内侧植入物位置不当的患者。胸肌滑脱在术前检查中被成功诊断，并通过旨在平衡周围力量从而纠正位置不当的特定手术程序得以纠正。
在一些胸肌下隆乳术后的患者中可发现导致内侧位置不当的胸肌滑脱。这种畸形的病因尚不清楚，但推测是由解剖学易感性引起的，在胸肌下腔隙形成过程中，胸小肌和/或未完全松解的胸大肌或副胸大肌无意中形成了滑脱。
