Abdelkader Rasha, Raafat Sarah, Sakr Wael, Abdelaziz Mohamed, ElNoamany Sameh
Department of Plastic Surgery, Faculty of Medicine, Cairo University, Egypt.
Department of Plastic Surgery, Faculty of Medicine, Beni Suef University, Egypt.
Plast Reconstr Surg Glob Open. 2022 Jun 15;10(6):e4349. doi: 10.1097/GOX.0000000000004349. eCollection 2022 Jun.
Planning a combined procedure requires ensuring an optimal fill of the reduced breast skin envelope, which in turn requires a system to quantify skin excess to ensure that the selected implant achieves that optimal fill. This has led us to develop a five-step approach that a surgical team can use to assess patients scheduled to undergo an augmentation mastopexy and arrive at an optimal surgical strategy.
This retrospective study included 50 consecutive cases where layered mastopexies combined with augmentation mammaplasties were performed. Step 1 entailed a preoperative examination and evaluation of the breasts. In step 2, the breast volume was assessed. The pocket plane was determined in step 3. The choice of which surgical technique to use was done in step 4, and in step 5, the horizontal skin excess was assessed.
The average implant size was 300 cm (range: 170-350 cm). The overall revision rate was 4%: on average, revision surgeries were performed 24 months after the first surgery. The average implant size was 300 cm (range: 170-350 cm).
Early results of single-stage augmentation with mastopexy have shown that the design of this systematic five-step approach demonstrates a great potential for producing reliable results with minimal risk. Using this five-step approach will improve patient and surgeon satisfaction and help to replace the old concept of "fill and re-drape" with a new one of "plan, reduce, fill, and re-drape."
规划联合手术需要确保缩小后的乳房皮肤包膜达到最佳填充效果，而这又需要一个系统来量化皮肤多余量，以确保所选植入物能实现该最佳填充效果。这促使我们开发了一种五步方法，手术团队可利用该方法评估计划接受隆乳上提术的患者，并制定出最佳手术策略。
这项回顾性研究纳入了连续50例行分层上提术联合隆乳术的病例。第一步是术前对乳房进行检查和评估。第二步评估乳房体积。第三步确定腔隙平面。第四步选择使用哪种手术技术，第五步评估水平方向的皮肤多余量。
植入物的平均大小为300立方厘米（范围：170 - 350立方厘米）。总体翻修率为4%：平均而言，翻修手术在首次手术后24个月进行。植入物的平均大小为300立方厘米（范围：170 - 350立方厘米）。
单阶段隆乳上提术的早期结果表明，这种系统性五步方法的设计在以最小风险产生可靠结果方面显示出巨大潜力。使用这种五步方法将提高患者和外科医生的满意度，并有助于用“规划、缩减、填充和重新塑形”这一新理念取代“填充和重新覆盖”的旧理念。
