Zou Haiting, Mo Ran, Wang Shuqin, Yan Xin, Lin Yue, Tan Qian
Department of Burns & Plastic Surgery, Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, Nanjing, China.
Department of Burns & Plastic Surgery, Nanjing Drum Tower Hospital, the Affiliated Hospital of Medical School of Nanjing University, Nanjing, China.
J Plast Reconstr Aesthet Surg. 2023 Feb;77:219-227. doi: 10.1016/j.bjps.2022.11.063. Epub 2022 Dec 7.
Polyacrylamide hydrogel has been prohibited since 2006 due to numerous complications. Unsatisfactory breast contour was always observed in patients after PAAG removal. The same occurred in patients after silicone prosthesis removal. We attempt to compare and analyze the difference in postoperative breast conditions and pathology between the two groups.
We retrospectively reviewed the data of patients who underwent PAAG or silicone prosthesis removal between 2011 and 2021. The BREAST-Q was used to evaluate the follow-up results, including satisfaction with breasts, physical well-being, psychosocial well-being, sexual well-being, and the operation.
A total of 63 patients were analyzed. The PAAG group complained of more lumps or indurations (p = 0.004), benefited less from operations as for symptomatic relief (p = 0.002), and had more chronic inflammation(p = 0.000) than the silicone group. No breast cancer was found. All the Breast-Q scores were lower in the PAAG group than in the silicone group, and there was a significant difference in satisfaction with physical well-being (p = 0.035). Besides, patients without symptoms tended to score higher in all aspects of Breast-Q than patients with symptoms after removal. The two groups (symptom & no symptom) differed in psychosocial well-being (p = 0.043) and satisfaction with operation (p = 0.048).
The breast contour of patients after PAAG or silicone prosthesis removal was worse than before. Early removal of PAAG before complications arise may result in a better surgical benefit. There is no doubt that PAAG are harmful both physically and psychologically. All patients are suggested to have PAAG injections removed.
自2006年起,聚丙烯酰胺水凝胶因引发众多并发症而被禁用。聚丙烯酰胺水凝胶取出术后患者的乳房外形往往不尽人意。硅胶假体取出术后患者也存在同样情况。我们试图比较和分析两组患者术后乳房状况及病理的差异。
我们回顾性分析了2011年至2021年间接受聚丙烯酰胺水凝胶或硅胶假体取出术患者的数据。采用BREAST-Q评估随访结果,包括对乳房的满意度、身体幸福感、心理社会幸福感、性幸福感以及对手术的满意度。
共分析了63例患者。与硅胶组相比,聚丙烯酰胺水凝胶组患者抱怨有更多肿块或硬结(p = 0.004),手术在缓解症状方面获益更少(p = 0.002),且慢性炎症更多(p = 0.000)。未发现乳腺癌。聚丙烯酰胺水凝胶组的所有BREAST-Q评分均低于硅胶组,在身体幸福感满意度方面存在显著差异(p = 0.035)。此外,无症状患者在取出术后BREAST-Q各方面的评分往往高于有症状患者。两组(有症状和无症状)在心理社会幸福感(p = 0.043)和手术满意度(p = 0.048)方面存在差异。
聚丙烯酰胺水凝胶或硅胶假体取出术后患者的乳房外形比术前更差。在并发症出现前尽早取出聚丙烯酰胺水凝胶可能会带来更好的手术效果。毫无疑问,聚丙烯酰胺水凝胶在生理和心理上都是有害的。建议所有患者取出聚丙烯酰胺水凝胶注射物。