Lampert Joshua A, Townsend Alexandra N, Shah Sunny, Bouz Antoun, Nichols Natasha
Aesthet Surg J Open Forum. 2023 Apr 12;5:ojad037. doi: 10.1093/asjof/ojad037. eCollection 2023.
Implant-based breast augmentation is one of the most popular plastic surgery procedures performed worldwide. As the number of patients who have breast implants continues to rise, so does the number of those who request breast implant removal without replacement. There is little in the current scientific literature describing total intact capsulectomy and simultaneous mastopexy procedures.
Here, the authors present their current method using the mammary imbrication lift and fixation technique after explant and total capsulectomy.
Between 2016 and 2021, a total of 64 patients (mean age: 42.95 years; range, 27-78 years) underwent the described mammary imbrication lift and fixation technique with bilateral breast implant removal and total capsulectomy.
Mean follow-up was 6.5 months (range, 1-36 months). Postoperative complications included minor cellulitis in 1 patient (1.6%), late onset hematoma with infection in 1 patient (1.6%), fat necrosis and pulmonary embolism in 1 patient with prior history of thromboembolic events (1.6%), and breast scar irregularity in 4 patients (6.2%) who required subsequent minor scar revision or steroid injections. Two patients (1.6%) underwent revision surgery with bilateral breast fat grafting to improve shape and add volume.
The mammary imbrication lift and fixation technique described here can safely and simultaneously be performed with a total intact capsulectomy and explant procedure. This technique avoids wide undermining, intentionally opening the capsule, performing subtotal capsulectomy, and preserving blood supply to the breast tissue and nipple with low complication rates.
基于植入物的隆乳术是全球最受欢迎的整形手术之一。随着接受乳房植入物的患者数量持续增加，要求移除乳房植入物且不再植入的患者数量也在上升。目前的科学文献中几乎没有描述完整包膜切除术和同期乳房上提术的内容。
在此，作者介绍了他们在外植体取出和完整包膜切除术后使用乳腺叠瓦状提升固定技术的当前方法。
2016年至2021年期间，共有64例患者（平均年龄：42.95岁；范围27 - 78岁）接受了所述的乳腺叠瓦状提升固定技术，同时进行双侧乳房植入物取出和完整包膜切除术。
平均随访时间为6.5个月（范围1 - 36个月）。术后并发症包括1例患者出现轻微蜂窝织炎（1.6%），1例患者出现迟发性血肿伴感染（1.6%），1例有血栓栓塞事件病史的患者出现脂肪坏死和肺栓塞（1.6%），4例患者出现乳房瘢痕不规则（6.2%），这些患者需要随后进行轻微瘢痕修复或注射类固醇。2例患者（1.6%）接受了双侧乳房脂肪移植修复手术以改善外形并增加体积。
本文所述的乳腺叠瓦状提升固定技术可以与完整包膜切除术和外植体取出术安全、同时进行。该技术避免了广泛的皮下分离、故意打开包膜、进行部分包膜切除术，并以低并发症发生率保留了乳房组织和乳头的血供。
