Department of Plastic and Reconstructive Surgery, Ente Ospedaliero Cantonale, Lugano, Switzerland.
Plastic Surgery Group, Zurich, Switzerland.
J Plast Reconstr Aesthet Surg. 2023 Jul;82:200-208. doi: 10.1016/j.bjps.2023.04.017. Epub 2023 Apr 20.
The popularity of breast augmentation has seen a decrease in number in the recent years. Simultaneously, the request for breast implant removal has increased impressively. A total of 77 women undergoing breast implant removal with no exchange were divided into four groups depending on the type of "reverse surgery" following the explantation: simple implant removal, implant removal with lipofilling, implant removal with mastopexy, and implant removal with mastopexy and lipofilling. Following this, an algorithm was created to standardize the ideal "reverse" surgery. After surgery, all the patients were followed for at least 6 months to understand their level of satisfaction regarding the outcome of the surgery. The majority of patients were highly satisfied after explantation. Implant-related issues were found to be the main cause for explantation surgery. Capsulectomy was performed in the minority of cases, as the capsule was found to be an ideal layer for fat grafting. Grouping the patients into 4 categories allowed us to investigate a pattern behind the decision to undergo a certain type of secondary procedure and to create an algorithm with general rules that can be used as a guide for surgeons. The increased demand for this type of surgery underlines a new interesting trend in plastic surgery that, together with Breast Implant-Associated Anaplastic Large Cell Lymphoma advent, will probably have implications on the communication between surgeons and patients and most likely on the choice of choosing different ways of breast volume augmentation.
近年来，隆胸的受欢迎程度有所下降，同时，要求取出乳房植入物的人数显著增加。共有 77 名女性接受了无需更换的乳房植入物取出手术，根据取出后“反向手术”的类型将其分为四组：单纯植入物取出、植入物取出伴脂肪填充、乳房提升伴植入物取出和乳房提升伴脂肪填充。在此之后，创建了一个算法来规范理想的“反向”手术。手术后，所有患者至少随访 6 个月，以了解他们对手术结果的满意度。大多数患者在取出后非常满意。植入物相关问题被认为是取出手术的主要原因。少数情况下进行了包膜切除术，因为发现包膜是脂肪移植的理想层。将患者分为 4 组有助于我们研究决定进行某种类型的二次手术的模式，并创建一个具有一般规则的算法，作为外科医生的指南。对这种类型手术的需求增加突显了整形手术的一个新的有趣趋势，随着乳腺癌相关间变性大细胞淋巴瘤的出现，这可能会对外科医生和患者之间的沟通产生影响，并很可能影响选择不同的乳房体积增大方式。
