Biggs T M, Yarish R S
Department of Surgery, St. Joseph Hospital, Houston, Texas.
Clin Plast Surg. 1988 Oct;15(4):549-55.
Although the weight of evidence generally indicates that improved contracture rates with retropectoral placement of the prosthesis and excellent aesthetic results can be obtained with this approach, there remains a significant cadre of surgeons who believe their own retromammary results are equal to or better than the alternative. Our experience with retromammary augmentation since 1963 indicates that fibrous capsular contracture around the implant is a persistent sequela. By placing the prosthesis behind the pectoral muscle, we believe we have achieved a significant decrease in this occurrence. Whereas there are a variety of hypothetical explanations for this observation, it may be that interposition of additional soft tissue between the implant and the observer may disguise the otherwise apparent problem, thus making its correction more apparent than real. Whatever the explanation, however, we have had fewer patients requiring fibrous capsule release and a higher incidence of patient satisfaction by placing the prosthesis behind the pectoral muscle.
尽管大量证据总体表明，采用胸大肌后放置假体的方法可提高挛缩率并获得出色的美学效果，但仍有相当一部分外科医生认为他们自己采用乳腺后放置假体的效果与前者相当或更好。我们自1963年以来进行乳腺后隆乳术的经验表明，植入物周围的纤维包膜挛缩是一种持续存在的后遗症。通过将假体置于胸大肌后方，我们认为已使这种情况的发生率显著降低。对于这一观察结果有多种假设性解释，可能是植入物与观察者之间额外软组织的介入掩盖了原本明显的问题，从而使其矫正看起来比实际情况更明显。然而，无论原因是什么，通过将假体置于胸大肌后方，需要进行纤维包膜松解的患者较少，患者满意度更高。
