Plastic and Reconstructive Surgery Department, Faculty of Medicine, Menoufia University, Yassein Abdelafar Street, Shebin Elkom, Egypt.
Plastic and Reconstructive Surgery Department, Ahmed Maher Teaching Hospitals, Cairo, Egypt.
Aesthetic Plast Surg. 2022 Apr;46(2):686-693. doi: 10.1007/s00266-021-02576-x. Epub 2021 Oct 22.
Revision augmentation-mastopexy is a complex procedure that aims to correct the complications of a previous surgery. The purpose of this study was to evaluate the reliability of the inferior-based dermoglandular flap with partial subpectoral implant coverage to correct implant- and tissue-related complications associated with primary subglandular breast augmentation and its influence on improving outcomes.
This was a retrospective study in which a total of 53 patients (106 breasts) underwent revision augmentation-mastopexy using the double coverage technique for an implant with an inferior-based dermoglandular flap and superior-based pectoralis major muscle (biplane) as the first layer and a nipple-areolar flap with breast pillars as the second layer. This technique provides a suspensory reconstruction that acts as hammock to minimize the pressure on the inframammary fold and maintain position integrity.
The follow-up period ranged from 2.3 to 4 years (mean 3.6 years), and the recorded complications were minor wound dehiscence less than 1 cm at the "T" junction in three breasts (2.83 %) and mild hypertrophic scarring in five breasts (4.72%).
The use of an inferior-based dermoglandular flap with partial subpectoral biplane implant reinforcement allows autologous support and double coverage to decrease the incidence of implant- and tissue-related complications, especially pseudoptosis, lower pole widening, capsular contracture, rippling, and implant visibility. It achieves enhanced upper pole fullness, medial cleavage, projection, and breast volume.
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翻修乳房提升术是一种旨在纠正先前手术并发症的复杂手术。本研究的目的是评估下蒂乳晕皮瓣与部分胸肌下植入物覆盖的可靠性，以纠正与原发性胸下乳房增大相关的植入物和组织相关并发症，并评估其对改善结果的影响。
这是一项回顾性研究，共有 53 名患者（106 只乳房）接受了翻修乳房增大术，采用双覆盖技术，使用下蒂乳晕皮瓣和上蒂胸大肌（双平面）作为第一层，乳头乳晕瓣和乳房支柱作为第二层。该技术提供了一种悬吊重建，起到吊床的作用，以最小化对乳晕下褶皱的压力并保持位置完整性。
随访时间为 2.3 至 4 年（平均 3.6 年），记录的并发症包括 3 只乳房（2.83%）在“T”形交界处有小于 1 厘米的小切口裂开和 5 只乳房（4.72%）有轻度增生性瘢痕。
使用下蒂乳晕皮瓣和部分胸肌下双平面植入物强化可以实现自体支撑和双覆盖，降低植入物和组织相关并发症的发生率，特别是假性下垂、下极增宽、包膜挛缩、波纹和植入物可见度。它可以实现上极饱满度、内侧分离、突出度和乳房体积的增强。
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