From the Department of Radiology, New York-Presbyterian Hospital, Columbia University Medical Center, 622 W 168th St, MC-28, New York, NY 10032 (D.J.L., T.T.W., J.K.K.); and the Department of Radiology, NYU Langone Medical Center-Hospital for Joint Diseases, New York, NY (G.A.C.).
Radiographics. 2017 Nov-Dec;37(7):2145-2163. doi: 10.1148/rg.2017170090.
Soft-tissue augmentation and implants are increasingly seen by the radiologist as more techniques emerge for a variety of indications and locations. Some surgical and implant procedures are performed for purely cosmetic reasons in otherwise healthy patients seeking to improve their body image, and some are performed for reconstruction after cancer or other chronic illnesses. Abdominoplasty, liposuction, and autologous fat grafting can be performed for abdominal and gluteal contouring. Injection of liquid injectable silicone has historically been fraught with legal issues, although it continues to be used for augmentation in a variety of anatomic locations. Newer solid silicone implants have revolutionized cosmetic and reconstructive muscular contouring. Subdermal implants placed by nonmedical professionals are relatively new and unrecognized within the medical establishment, although such implants have been described in the popular culture. Perhaps the most rapidly increasing segment of cosmetic procedures, however, is minimally invasive cosmesis in the form of soft-tissue fillers in the hands and face. Finally, the major principles of breast augmentation and penile implants are also reviewed. Regardless of the location and the type of implant, complications of plastic surgery and soft-tissue implants can generally be classified into the following categories: seroma, hematoma, infection, migration, vascular or nerve compression, fibrosis, foreign-body reaction, and rupture or breakdown. Key concepts include knowing the appropriate anatomic location and the normal postoperative appearance so that complications can be properly detected. A broad range of approved, off-label, and illicit plastic surgical and implant procedures are described and their complications illustrated with cases with classic imaging findings. RSNA, 2017.
软组织填充和植入物越来越多地受到放射科医生的关注，因为各种适应证和部位的技术不断涌现。一些手术和植入程序纯粹是出于美容原因而进行的，在健康状况良好的患者中，他们希望改善自己的身体形象，而另一些则是在癌症或其他慢性疾病后进行重建。腹部整形术、抽脂术和自体脂肪移植术可用于腹部和臀部轮廓塑造。注射液态可注射硅胶在历史上一直存在法律问题，尽管它仍继续用于各种解剖部位的填充。新型固体硅胶植入物彻底改变了美容和重建肌肉轮廓。由非专业医疗人员放置的皮下植入物是相对较新的，在医疗领域尚未得到认可，尽管在流行文化中已经有过相关描述。然而，美容程序中增长最快的部分可能是手部和面部软组织填充剂的微创美容。最后，还回顾了乳房增大和阴茎植入物的主要原则。无论植入部位和植入物类型如何，整形手术和软组织植入物的并发症一般可分为以下几类：血清肿、血肿、感染、移位、血管或神经压迫、纤维化、异物反应和破裂或破损。关键概念包括了解适当的解剖位置和正常的术后外观，以便正确检测并发症。本文描述了广泛的批准、非适应证和非法的整形手术和植入物程序，并通过具有典型影像学表现的病例来说明其并发症。RSNA，2017 年。
