Grünherz Lisanne, Burger Anna, Giovanoli Pietro, Lindenblatt Nicole
Department of Plastic and Reconstructive Surgery, University Hospital Zurich, Zurich, Switzerland.
Gland Surg. 2019 Oct;8(5):516-526. doi: 10.21037/gs.2019.09.05.
The aim of a mastopexy is to raise the breast projection, tighten the skin envelope, and place the nipples in an optimal position in projection to the inframammary fold. This procedure is often combined with prosthetic implants or an autoimplant. Given the current increasing demand for the use of autologous tissue, we evaluated mastopexies combined with either an autoimplant or prosthetic implant in terms of patient satisfaction and long-term results.
We evaluated 34 patients who underwent a mastopexy with simultaneous breast prosthesis or an autoimplant. During follow-ups we obtained standardized breast measurements, BREAST-Q score, and pre- and postoperative photographs to perform photometric measurements.
BREAST-Q score of patients that underwent autoimplant-mastopexies revealed a higher patient satisfaction with significant differences in satisfaction with breast appearance (69±18 55±16, P=0.03) and outcome (71±18 48±26, P=0.009). Regarding breast shape, photometric evaluations presented a significantly different breast shape with higher upper pole fullness in augmentation-mastopexy patients. No statistical significance between long-term results and complication rates could be observed in either patient groups.
The BREAST-Q score implies a higher overall long-term satisfaction in patients that received autoimplant-mastopexy with similar long-term results compared with augmentation-mastopexy. Nevertheless, individual decision-making is necessary and should be based on the degree of ptosis, existing breast volume, previous operations, and patients' preferences regarding postoperative breast shape and projection.
乳房上提术的目的是增加乳房凸度、收紧皮肤包膜,并将乳头置于相对于乳房下皱襞的最佳位置。该手术常与假体植入或自体组织植入相结合。鉴于目前对自体组织使用的需求不断增加,我们从患者满意度和长期效果方面评估了乳房上提术联合自体组织植入或假体植入的情况。
我们评估了34例行乳房上提术同时植入乳房假体或自体组织的患者。在随访期间,我们获取了标准化的乳房测量数据、BREAST-Q评分以及术前和术后照片以进行光度测量。
接受自体组织植入乳房上提术的患者的BREAST-Q评分显示患者满意度更高,在对乳房外观的满意度(69±18对55±16,P=0.03)和手术效果(71±18对48±26,P=0.009)方面存在显著差异。关于乳房形状,光度评估显示隆乳上提术患者的乳房形状有显著差异,上极饱满度更高。两组患者在长期效果和并发症发生率之间均未观察到统计学意义。
BREAST-Q评分表明,与隆乳上提术相比,接受自体组织植入乳房上提术的患者总体长期满意度更高,长期效果相似。然而,个体决策是必要且应基于乳房下垂程度、现有乳房体积、既往手术情况以及患者对术后乳房形状和凸度的偏好。