Sowa Yoshihiro, Kodama Takuya, Fuchinoue Yuko, Inafuku Naoki, Terao Yasunobu
Departments of Plastic and Reconstructive Surgery, Kyoto Prefectural University of Medicine, Graduate School of Medical Sciences, Kyoto, Japan.
Department of Plastic and Reconstructive Surgery, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Tokyo, Japan.
Plast Reconstr Surg Glob Open. 2022 Jan 3;10(1):e3965. doi: 10.1097/GOX.0000000000003965. eCollection 2022 Jan.
Breast reconstruction with immediate placement of breast implants (direct-to-implant methods) following nipple-sparing mastectomy has increased because of the low burden on the patient and good aesthetic results. However, nipple-areolar complex (NAC) malposition after this surgery remains a common complication that has yet to be entirely resolved. Here, we introduce an approach using Duoactive CGF to prevent postoperative NAC malposition. Immediate postoperative fixation of Duoactive CGF cranially to the NAC of the operated breast was applied for 2-4 weeks. This is referred to as a breast splint. In the study, nine patients who received breast splints and 15 patients who did not were enrolled. The NAC position on the splint-treated breast was compared with that on the healthy side within 6 months after surgery. A case with little visual malposition was defined as having a good outcome, based on the deviation in the cranial direction not exceeding the position of the contralateral NAC. Our preliminary data demonstrated that the rate of good outcomes was significantly higher ( = 0.028) in cases in which a breast splint was used, compared with those that were not treated with a breast splint (7/9, 78.8% versus 4/15, 26.7%). Postoperative application of a breast splint using Duoactive CGF is a simple and useful method to prevent NAC malposition after breast reconstruction, using a direct-to-implant method.
由于对患者负担小且美学效果良好，保留乳头的乳房切除术后立即植入乳房假体进行乳房重建（直接植入法）的情况有所增加。然而，该手术后乳头乳晕复合体（NAC）位置异常仍是一个常见并发症，尚未得到完全解决。在此，我们介绍一种使用双活性浓缩生长因子（Duoactive CGF）预防术后NAC位置异常的方法。术后立即将双活性CGF在颅骨方向固定于手术侧乳房的NAC上，持续2至4周。这被称为乳房夹板。在该研究中，纳入了9例接受乳房夹板治疗的患者和15例未接受治疗的患者。在术后6个月内，将接受夹板治疗乳房的NAC位置与健康侧的NAC位置进行比较。根据颅骨方向的偏差不超过对侧NAC的位置，将视觉上位置异常不明显的病例定义为预后良好。我们的初步数据表明，与未使用乳房夹板治疗的病例相比，使用乳房夹板的病例预后良好率显著更高（P = 0.028）（7/9，78.8% 对比 4/15，26.
