Deveaux C, Calibre C, Duquennoy-Martinot V, Guerreschi P, Dumont A
Service de chirurgie plastique, reconstructrice et esthétique et centre de traitement des Brûlés, hôpital Roger-Salengro, centre hospitalier et universitaire de Lille, avenue Émile-Laine, 59037 Lille cedex, France.
Service de chirurgie plastique, reconstructrice et esthétique et centre de traitement des Brûlés, hôpital Roger-Salengro, centre hospitalier et universitaire de Lille, avenue Émile-Laine, 59037 Lille cedex, France.
Ann Chir Plast Esthet. 2020 Jul;65(4):284-293. doi: 10.1016/j.anplas.2020.05.004. Epub 2020 May 29.
For the past decades, number of prophylactic bilateral mastectomies using reconstruction with implants increases. We describe a new surgical strategy and analyse its safety and feasability.
It is a retrospective, descriptive and monocentric study. The first step of surgery consisted in obteining a peri-prosthetic capsule with implants and if there was a mammary hypertrophy and/or ptosis, it was corrected at the same time. The second step of surgery was the nipple-sparing mastectomy with change of implants for bigger ones. Third step consisted in a lipofilling.
Seven patients were included. 6 women had a BRCA1 gene mutation. Mean age was 35.6 year-old [29.6; 41.6], mean BMI was 23.8kg/m [20.6; 27], mean chest circumference was 93.7cm [87.4; 100], mean cup was C- [B-; D-]. 4 women had mammary hypertrophy and/or ptosis. Mean number of procedure per woman was 3.6 [2.5; 4.7]. Mean volume of implants used at the first step was 248.6ml [211.3; 285.9]. The second step was performed mean 33.9 weeks [22.3; 45.5] later. Mean increase of implants volume was 120ml [80.4; 159.6]. 4 patients had complications including 1 who had implant exposure. Six patients had lipofilling of mean volume per breast of 175ml [116; 234].
This new strategy could decrease complication rate, improve aesthetic outcome and decrease psychological impact of surgery.
在过去几十年中，采用植入物重建的预防性双侧乳房切除术的数量有所增加。我们描述了一种新的手术策略，并分析其安全性和可行性。
这是一项回顾性、描述性的单中心研究。手术的第一步是用植入物获得假体周围包膜，如果存在乳腺肥大和/或乳房下垂，则同时进行矫正。手术的第二步是保留乳头的乳房切除术，更换为更大的植入物。第三步是脂肪填充。
纳入7例患者。6名女性存在BRCA1基因突变。平均年龄为35.6岁[29.6；41.6]，平均体重指数为23.8kg/m²[20.6；27]，平均胸围为93.7cm[87.4；100]，平均罩杯为C-[B-；D-]。4名女性存在乳腺肥大和/或乳房下垂。每位女性的平均手术次数为3.6次[2.5；4.7]。第一步使用的植入物平均体积为248.6ml[211.3；285.9]。第二步平均在33.9周[22.3；45.5]后进行。植入物体积平均增加120ml[80.4；159.6]。4例患者出现并发症，其中1例发生植入物外露。6例患者进行了脂肪填充，每侧乳房的平均填充量为175ml[116；234]。
这种新策略可以降低并发症发生率，改善美学效果，并减少手术对心理的影响。
