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肥胖症手术后体重减轻患者的臀肌植入物与自体皮瓣:下半身提升术后三维臀部突出的前瞻性对比研究。

Gluteal Implants Versus Autologous Flaps in Patients with Postbariatric Surgery Weight Loss: A Prospective Comparative Study of 3-Dimensional Gluteal Projection After Lower Body Lift.

作者信息

Levan Philippe, Bassilios Habre Samer

机构信息

Department of Plastic and Reconstructive Surgery, Groupe Hospitalier Paris Saint-Joseph, Paris, France.

出版信息

Aesthet Surg J. 2017 Oct 1;37(9):1012-1021. doi: 10.1093/asj/sjx033.

Abstract

BACKGROUND

Deformities and excess skin resulting from massive weight loss are corrected with circumferential lower body lift (LBL). The gluteal area is frequently flattened due to aggressive skin excision during LBL. Gluteal implants can circumvent this problem.

OBJECTIVES

We aimed to objectively evaluate the outcomes of gluteal augmentation with implants versus flap surgery performed simultaneously with LBL.

METHODS

Between January 2014 and June 2015, twenty-seven patients underwent LBL with gluteal implants (10 patients), flaps (14 patients), or no gluteal augmentation (3 patients) in our hospital. Three-dimensional analysis was used to assess gluteal projection preoperatively and at 6 months. Gain in projection, pain scores, complications, and patient and surgeon satisfaction were compared.

RESULTS

The mean follow-up duration was 18 months. The mean gain in projection at 6 months was 4.9 mm in the implant group, -0.5 mm in the flap group (P = 0.1), and -9.6 mm in the control group. The mean implant volume was 294.5 mL. Operation time was shorter in the flap group (192 min) than in the implant group (218 min, P = 0.001). Surgeon satisfaction was higher in the implant group (P = 0.007). Implants were more painful than flaps at 4 days and 2 weeks (P = 0.004 for both). There were 6 minor complications (60%) in the implant group versus 7 (50%) in the flap group (P = 0.94).

CONCLUSIONS

In selected patients, LBL with gluteal implants is safe and slightly increases gluteal projection.

LEVEL OF EVIDENCE

摘要

背景

通过环形下半身提升术(LBL)可矫正因大量体重减轻导致的畸形和多余皮肤。在LBL手术中,由于积极的皮肤切除,臀区常常会变平。臀植入物可以解决这个问题。

目的

我们旨在客观评估在LBL同时进行臀植入物增大术与皮瓣手术的效果。

方法

2014年1月至2015年6月期间,我院27例患者接受了LBL手术,其中10例患者进行了臀植入物手术,14例患者进行了皮瓣手术,3例患者未进行臀增大术。采用三维分析方法在术前和术后6个月评估臀突度。比较突度增加量、疼痛评分、并发症以及患者和外科医生的满意度。

结果

平均随访时间为18个月。植入物组6个月时突度平均增加4.9mm,皮瓣组为-0.5mm(P = 0.1),对照组为-9.6mm。植入物平均体积为294.5mL。皮瓣组手术时间(192分钟)比植入物组(218分钟)短(P = 0.001)。植入物组外科医生满意度更高(P = 0.007)。在术后4天和2周时,植入物比皮瓣更疼痛(两者P均 = 0.004)。植入物组有6例轻微并发症(60%),皮瓣组有7例(50%)(P = 0.94)。

结论

对于选定的患者,LBL联合臀植入物手术是安全的,且能轻微增加臀突度。

证据级别

2级。

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