From DuPage Medical Group/DMG Aesthetics and the Department of Plastic Surgery, Central DuPage Hospital/Northwestern Medicine; and Department of Plastic Surgery, Loma Linda University Medical Center.
Plast Reconstr Surg. 2019 Jul;144(1S Utilizing a Spectrum of Cohesive Implants in Aesthetic and Reconstructive Breast Surgery):66S-72S. doi: 10.1097/PRS.0000000000005952.
Inspira round implants have a higher fill ratio than standard round implants and the 3 available implant types have increasing gel cohesivity. Collectively, these features may help provide a fuller upper pole and help reduce the risk of rippling, visible implant edges, and palpability and may be particularly beneficial in patients undergoing prepectoral reconstruction. Patient outcomes after prepectoral revision reconstruction with these implants are reviewed in this study.
This retrospective study included consecutive patients who had previously undergone subpectoral (dual plane), implant-based, breast reconstruction and presented for revision reconstruction between June 2015 and January 2018. Reasons for revision included animation deformity, pain, asymmetry implant malposition, size change, capsular contracture, and rippling. Revision reconstruction involved implant removal, site change from subpectoral to prepectoral, and immediate implant replacement in all patients. Complications after revision reconstruction were obtained from patient records.
A total of 64 patients (124 breasts) met the inclusion criteria. During a mean follow-up period of 18.9 months, complications occurred in 4 breasts (3.2%) and included implant loss (1.6%), seroma (1.6%), hematoma (0.8%), surgical site infection (0.8%), and skin necrosis (0.8%). There was no incidence of capsular contracture and presenting complaints were resolved in all cases.
Prepectoral reconstruction, in conjunction with Inspira round implants, appears to be a safe and effective approach in suitable patients presenting for revision surgery, at least in the short term. Implant features facilitate prepectoral implant placement, resulting in pleasing aesthetic outcomes. Whether these outcomes will withstand the test of time remains to be seen.
Inspira 圆形植入物的填充比例高于标准圆形植入物，且这 3 种可用的植入物类型的凝胶内聚性逐渐增加。这些特征共同作用，可能有助于提供更饱满的上部杆状结构，并有助于降低波纹、可见的植入物边缘、触诊和可感知性的风险，对于接受胸肌前置重建的患者尤其有益。本研究回顾了这些植入物用于胸肌前置修复重建后的患者结局。
这是一项回顾性研究，纳入了 2015 年 6 月至 2018 年 1 月期间因先前接受过胸肌下（双平面）、基于植入物的乳房重建并就诊行修复重建的连续患者。修复重建的原因包括动画变形、疼痛、植入物位置不对称、大小改变、包膜挛缩和波纹。所有患者均行植入物取出、从胸肌下到胸肌前置的部位改变以及即刻植入物置换。从患者病历中获取修复重建后的并发症。
共有 64 名患者（124 侧乳房）符合纳入标准。在平均 18.9 个月的随访中，4 侧乳房（3.2%）出现并发症，包括植入物丢失（1.6%）、血清肿（1.6%）、血肿（0.8%）、手术部位感染（0.8%）和皮肤坏死（0.8%）。无包膜挛缩发生，所有病例的主诉均得到解决。
对于接受过乳房重建且适合行修复手术的患者，胸肌前置重建联合 Inspira 圆形植入物似乎是一种安全有效的方法，至少在短期内如此。植入物的特点有助于胸肌前置的植入物放置，从而获得令人满意的美学效果。这些结果是否经得起时间的考验仍有待观察。
