Ishii Naohiro, Ando Jiro, Harao Michiko, Takemae Masaru, Kishi Kazuo
Department of Plastic and Reconstructive Surgery, Keio University, Shinjyuku Ward, Tokyo, Japan.
Department of Breast Surgery, Tochigi Cancer Center, Utsunomiya City, Tochigi, Japan.
Eplasty. 2017 Aug 18;17:e22. eCollection 2017.
In breast reconstruction, decision of projection of silicone breast implant in tissue expander replacement is difficult because of the need to consider several parameters that cannot be expressed in accurate numerical form. The present study aimed at a quantitative analysis based on decreased projection of the reconstructed side compared with silicone breast implant projection and to develop a new method for simple and practical decision of silicone breast implant projection. Thirty-five patients who had mammary carcinoma and were treated with simple mastectomy, tissue expander insertion, and replacement with anatomical silicone breast implant from April 2013 to March 2016 were retrospectively identified. We recorded the projection of used silicone breast implant (Pi). The projections of reconstructed breast 6 months after silicone breast implant insertion (Pr) and that of the unaffected breast during silicone breast implant selection (Pu) were measured. The difference between Pi and Pr was defined as the revised numerical value (Rev). We investigated whether Rev significantly differed according to age, body mass index, or Pu and analyzed correlations between Rev and age, Pu, and body mass index. Mean Rev in all patients was 1.2 ± 0.3 cm. Rev was significantly higher in patients with higher body mass index than in those with lower body mass index ( < .01) and in patients with higher Pu than in those with lower Pu ( < .01). Significant positive correlations of Rev with body mass index and Pu were found (β = .63, < .01 and β = .67, < .01, respectively). Rev was a simple, practical, and cost-effective concept. We believe that it is a useful indicator for deciding silicone breast implant projection.
在乳房重建中,由于需要考虑几个无法以精确数值形式表示的参数,因此在组织扩张器置换中决定硅胶乳房植入物的突出度很困难。本研究旨在基于与硅胶乳房植入物突出度相比重建侧突出度降低进行定量分析,并开发一种简单实用的方法来决定硅胶乳房植入物的突出度。回顾性确定了2013年4月至2016年3月期间35例患有乳腺癌并接受了单纯乳房切除术、组织扩张器植入以及解剖型硅胶乳房植入物置换的患者。我们记录了所用硅胶乳房植入物的突出度(Pi)。测量了硅胶乳房植入物植入后6个月重建乳房的突出度(Pr)以及硅胶乳房植入物选择期间未受影响乳房的突出度(Pu)。Pi与Pr之间的差异定义为修正数值(Rev)。我们研究了Rev是否根据年龄、体重指数或Pu有显著差异,并分析了Rev与年龄、Pu和体重指数之间的相关性。所有患者的平均Rev为1.2±0.3厘米。体重指数较高的患者的Rev显著高于体重指数较低的患者(P<0.01),Pu较高的患者的Rev显著高于Pu较低的患者(P<0.01)。发现Rev与体重指数和Pu存在显著正相关(β = 0.63,P<0.01和β = 0.67,P<0.01)。Rev是一个简单、实用且具有成本效益的概念。我们认为它是决定硅胶乳房植入物突出度的一个有用指标。