From the Department of Plastic Surgery and Burns Treatment, Copenhagen University Hospital, Rigshospitalet; and Amalieklinikken.
Plast Reconstr Surg. 2021 Jun 1;147(6):940e-947e. doi: 10.1097/PRS.0000000000007991.
Anatomical implants provide a wide range of options in terms of implant dimensions for breast augmentation. Nevertheless, many surgeons choose not to use anatomical implants due to the risk of rotation malposition and because their advantages over round implants are not clearly defined.
A retrospective review of medical records was performed on all women who underwent breast augmentation or implant exchange with microtextured anatomical implants from 2012 to 2019 in a single private clinic. The authors focused on the outcomes of a subgroup of women with glandular ptosis and nipple placement below the inframammary fold who underwent breast augmentation with anatomical implants. Furthermore, the incidence and risk factors for implant rotation were analyzed.
In total, 653 women underwent primary breast augmentation (n = 529) or implant exchange (n = 124) with anatomical implants. The median follow-up period was 2.7 years (interquartile range, 1.6 to 3.9 years). The incidence of implant rotation was 14 (2.6 percent) in the primary augmentation group and four (3.2 percent) in the implant exchange group. Implant rotation was not associated with type of surgery (p = 0.76), implant projection (p = 0.23), or implant height (p = 0.48). The authors successfully used anatomical implants to elevate the nipple in 92.9 percent of the women with glandular ptosis without using a mastopexy.
The study results indicate that the rotation risk with microtextured implants is similar to that with macrotextured implants. Furthermore, the authors found that high-projection anatomical implants can be used as an alternative to augmentation-mastopexy in women with glandular ptosis.
CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, III.
解剖型植入物在乳房增大方面提供了广泛的植入物尺寸选择。然而，许多外科医生由于担心旋转错位以及解剖型植入物的优势不明确而选择不使用解剖型植入物。
对 2012 年至 2019 年期间在一家私人诊所接受微纹解剖型植入物乳房增大或植入物置换的所有女性的病历进行回顾性研究。作者重点关注一组乳房腺体下垂和乳头位于乳房下皱襞以下的女性接受解剖型植入物乳房增大的结果。此外，还分析了植入物旋转的发生率和危险因素。
共有 653 名女性接受了解剖型植入物的初次乳房增大（n=529）或植入物置换（n=124）。中位随访时间为 2.7 年（四分位距，1.6 至 3.9 年）。原发性增大组中植入物旋转的发生率为 14 例（2.6%），植入物置换组为 4 例（3.2%）。手术类型（p=0.76）、植入物突度（p=0.23）或植入物高度（p=0.48）与植入物旋转无关。作者成功地在 92.9%的腺体下垂女性中使用解剖型植入物提升乳头，而无需进行乳房成形术。
研究结果表明，微纹植入物的旋转风险与大纹植入物相似。此外，作者发现高突度解剖型植入物可作为腺体下垂女性乳房增大-乳房成形术的替代方法。
临床问题/证据水平：治疗性，III 级。
