Sim Hyung-Bo, Sun Sang-Hoon
Drs Sim and Sun are plastic surgeons in private practice in Seoul, Republic of Korea.
Aesthet Surg J. 2015 Nov;35(8):952-61. doi: 10.1093/asj/sjv104. Epub 2015 Jun 23.
At its inception, transaxillary breast augmentation was a blind technique associated with complications and unpredictable outcomes. The transaxillary approach now involves electrocautery dissection with direct endoscopic visualization and yields excellent aesthetic outcomes with a concealed scar. Shaped implant devices can be combined with transaxillary augmentation for natural-appearing results that can be individualized to the patient.
The authors sought to improve the results of transaxillary endoscopic breast augmentation by placing shaped gel implants in patients with an indistinct or absent inframammary fold (IMF), who wished to avoid a breast scar.
One hundred sixteen Asian women underwent transaxillary endoscopic breast augmentation with electrocautery dissection and were evaluated in a prospective study. A partial retropectoral plane pocket was created in 4 sequential dissection steps with direct endoscopic visualization and careful control of bleeding. Shaped cohesive gel implants were placed to produce smooth, natural-appearing breast mounds and well-defined IMFs.
Patients were monitored for 6 to 24 months after surgery (mean, 10 months; median, 12 months). There were no instances of pneumothorax, instrument-related skin burns, or severe implant deformation due to rotation or displacement of the implants postoperatively. Three of 116 patients (2.6%) experienced Baker 3 unilateral capsular contracture. One patient developed a unilateral hematoma at 3 weeks after surgery.
Endoscopic breast surgery is associated with shortened recovery times, a reduced need for drainage, and excellent outcomes, including a well-defined and symmetric IMF. This approach, combined with shaped gel implants, can yield natural-appearing results of transaxillary breast augmentation.
4 Therapeutic.
经腋窝隆胸术最初是一种盲目操作技术，常伴有并发症且效果不可预测。如今的经腋窝入路涉及使用电灼剥离并直接在内镜下可视化操作，能产生极佳的美学效果且疤痕隐蔽。成型植入装置可与经腋窝隆胸术相结合，以获得自然外观的效果，还可根据患者个体情况进行调整。
作者试图通过为乳房下皱襞（IMF）不明显或缺失且希望避免乳房疤痕的患者植入成型凝胶假体，来改善经腋窝内镜隆胸术的效果。
116名亚洲女性接受了经腋窝内镜隆胸术及电灼剥离，并纳入一项前瞻性研究进行评估。通过4个连续的剥离步骤在直视下创建部分胸大肌后间隙腔隙，并仔细控制出血。植入成型粘性凝胶假体以形成光滑、自然外观的乳房隆起和清晰的乳房下皱襞。
术后对患者进行了6至24个月的监测（平均10个月；中位数12个月）。术后未发生气胸、器械相关的皮肤灼伤或因假体旋转或移位导致的严重假体变形。116名患者中有3名（2.6%）出现贝克3级单侧包膜挛缩。1名患者在术后3周出现单侧血肿。
内镜下乳房手术恢复时间短，引流需求减少，效果极佳，包括清晰对称的乳房下皱襞。这种方法与成型凝胶假体相结合，可产生自然外观的经腋窝隆胸效果。
4级治疗性。
