Zimmerman Amanda L, Tugertimur Bugra, Smith Paul D, Kumar Ambuj, Dayicioglu Deniz
1 Division of Plastic Surgery, Department of Surgery, University of South Florida Morsani College of Medicine, Tampa, FL, USA.
2 Division of General Surgery, Hofstra Northwell School of Medicine, New York, NY, USA.
Cancer Control. 2017 Oct-Dec;24(4):1073274817729064. doi: 10.1177/1073274817729064.
Augmentation mammoplasty remains the most common cosmetic surgery procedure performed. The objective of this article is to evaluate the impact of augmented volume of the reconstructed breast in patients that undergo nipple-sparing mastectomy and patients previously augmented who undergo mastectomy with tissue expander/implant-based reconstruction.
Patients undergoing skin-sparing mastectomy, nipple-sparing mastectomy, and mastectomy after previous augmentation followed by tissue expander/implant-based reconstruction between June 2011 and April 2015 by 2 surgeons at the same institution were included. Retrospective chart review of the patients identified using these criteria was performed to record patient characteristics, complications, breast volume, implant volume, and percentage change in volume at the time of reconstruction. Percentage change of breast volume was calculated using the formula (implant breast weight)/(breast weight) for skin-sparing and nipple-sparing mastectomy patients and (final breast implant weight - [breast weight + augmentation breast implant weight])/([breast weight + augmentation breast implant]) for patients undergoing mastectomy following previous augmentation.
A total of 293 patients were included in the study with 63 patients who underwent nipple-sparing mastectomy, 166 patients who underwent skin-sparing mastectomy, and 64 patients who underwent previous augmentation with subsequent mastectomy. Mean percentage change in breast volume was 66% in the nipple-sparing mastectomy group, 15% for the right breast and 18% for the left breast in the skin-sparing mastectomy group, and 81% for the right breast and 72% for the left breast in the mastectomy following previous augmentation group. Complication rate for nipple-sparing mastectomy was 27%, mastectomy following previous augmentation was 20.3%, and skin-sparing mastectomy group was 18.7%.
Patients who undergo nipple-sparing mastectomy or mastectomy following previous augmentation have the ability to achieve greater volume in their reconstructed breast via tissue expander/implant-based reconstruction.
隆乳术仍是最常见的整形手术。本文的目的是评估在接受保留乳头的乳房切除术的患者以及先前接受过隆乳术且随后接受基于组织扩张器/植入物的乳房重建术的患者中，重建乳房增加的体积所产生的影响。
纳入2011年6月至2015年4月间由同一机构的2名外科医生进行的保留皮肤的乳房切除术、保留乳头的乳房切除术以及先前隆乳术后行基于组织扩张器/植入物的乳房重建术的患者。对符合这些标准的患者进行回顾性病历审查，以记录患者特征、并发症、乳房体积、植入物体积以及重建时体积的百分比变化。对于保留皮肤和保留乳头的乳房切除术患者，乳房体积的百分比变化使用公式（植入物乳房重量）/（乳房重量）计算；对于先前隆乳术后行乳房切除术的患者，使用公式（最终乳房植入物重量 - [乳房重量 + 隆乳乳房植入物重量]）/（[乳房重量 + 隆乳乳房植入物重量]）计算。
共有293例患者纳入研究，其中63例接受保留乳头的乳房切除术，166例接受保留皮肤的乳房切除术，64例先前接受过隆乳术随后行乳房切除术。保留乳头的乳房切除术组乳房体积的平均百分比变化为66%，保留皮肤的乳房切除术组右侧乳房为15%，左侧乳房为18%，先前隆乳术后行乳房切除术组右侧乳房为81%，左侧乳房为72%。保留乳头的乳房切除术的并发症发生率为27%，先前隆乳术后行乳房切除术为20.3%，保留皮肤的乳房切除术组为18.7%。
接受保留乳头的乳房切除术或先前隆乳术后行乳房切除术的患者，通过基于组织扩张器/植入物的乳房重建术能够在重建乳房中获得更大的体积。
