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乳房自动增大(乳房上提术和脂肪填充):一种停止使用乳房植入物的选择。

Breast Auto-augmentation (Mastopexy and Lipofilling): An Option for Quitting Breast Implants.

机构信息

Division of Plastic and Reconstructive Surgery, Hospital de Clínicas, Federal University of Paraná, Curitiba, Paraná, Brazil.

Pietà Medical Center, Rua Solimões, 1175, Merces, Curitiba, Paraná, 80810-070, Brazil.

出版信息

Aesthetic Plast Surg. 2019 Oct;43(5):1133-1141. doi: 10.1007/s00266-019-01387-5. Epub 2019 May 7.

Abstract

BACKGROUND

Breast augmentation with implants is one of the most commonly performed plastic surgical procedures, but has potential complications-asymmetry, implant displacement, rippling and wrinkling, capsular contracture, late seromas, and benign and malignant tumors-and potential financial costs. The auto-augmentation procedure, with mastopexy and lipofilling, is a second option to offer to patients who do not desire to continue with breast implants in secondary procedures.

OBJECTIVE

This study aimed to present a series of patients who intended to quit having breast implants, and they went to an auto-augmentation procedure, with mastopexy and lipofilling.

METHOD

The study included patients who underwent a mastopexy plus lipofilling following breast implant removal. The indications for the surgical procedure were: desire of not having breast implants anymore and smaller breasts, capsular contracture, and implant rupture. The surgical procedure is detailed. Fat grafting and mastopexy are done immediately at the time of explantation.

RESULTS

A total of 26 patients (mean age 59.1 years) underwent mastopexy plus lipofilling following breast implant removal. The mean follow-up was 18 months. The mean amount of lipofilling was 258 cc. No major complications were observed, no infection, dehiscence, hematoma, or seroma. One patient had an oil cyst which was handled with resection.

CONCLUSION

The auto-augmentation procedure after implant removal with local flaps and lipofilling is the better option for patients in whom breast implants are not an option anymore. Complication and reoperation rates are low and patient satisfaction is good.

LEVEL OF EVIDENCE IV

This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

摘要

背景

乳房假体隆乳术是最常施行的整形手术之一,但存在诸多潜在并发症,如不对称、假体移位、波纹和皱褶、包膜挛缩、迟发性血清肿、良性和恶性肿瘤以及潜在的经济成本。乳房提升术联合脂肪填充术是对不希望在二次手术中继续使用乳房假体的患者的另一种选择。

目的

本研究旨在介绍一组希望停止使用乳房假体的患者,他们选择了乳房提升术联合脂肪填充术。

方法

本研究纳入了接受乳房假体取出后行乳房提升术联合脂肪填充术的患者。手术适应证为:希望不再使用乳房假体且乳房较小、包膜挛缩和假体破裂。详细介绍了手术过程。脂肪移植和乳房提升术在假体取出的同时即刻进行。

结果

共有 26 例患者(平均年龄 59.1 岁)接受了乳房假体取出后行乳房提升术联合脂肪填充术。平均随访时间为 18 个月。平均脂肪填充量为 258cc。未观察到重大并发症,无感染、切口裂开、血肿或血清肿。1 例患者出现油性囊肿,行切除术处理。

结论

对于那些不再选择使用乳房假体的患者,采用局部皮瓣联合脂肪填充的自体隆乳术是更好的选择。并发症和再次手术率低,患者满意度高。

证据等级 IV:本杂志要求作者为每篇文章分配一个证据等级。如需详细了解这些循证医学等级,请参考目录或在线作者指南 www.springer.com/00266

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