Hefel Kerstin, Mahrhofer Maximilian, Russe Elisabeth, Moncher Johanna, Wechselberger Gottfried, Schwaiger Karl
Abteilung für Plastische, Rekonstruktive und Ästhetische Chirurgie, Krankenhaus der Barmherzigen Brüder Salzburg, Paracelsus Medizinische Universität Salzburg, Kajetanerplatz 1, 5020, Salzburg, Österreich.
Abteilung für Hand‑, Mikro- und rekonstruktive Brustchirurgie, Marienhospital Stuttgart, Lehrkrankenhaus der Eberhard Karls Universität Tübingen, Boeheimstr 37, 70199, Stuttgart, Deutschland.
Chirurgie (Heidelb). 2024 Jan;95(1):63-70. doi: 10.1007/s00104-023-01972-0. Epub 2023 Oct 25.
Breast augmentation is currently the leading aesthetic surgical procedure worldwide. Thus, there is a high prevalence of women with breast implants demanding serious know-how and expertise concerning long-term complication management. Breast implant carriers can suffer from problems and pathologies making implant removal the best solution. The authors of this article have also been confronted more and more with the unspecified complex of symptoms named breast implant disease (BID), also called breast implant illness (BII). The treatment of choice for BID is implant removal.
Analysis of problems and solutions regarding implant removal. Specific patient analysis according to patients' breast and body configuration. Technical considerations for surgery and preoperative planning. Evaluation of the authors' techniques.
Evaluation of all patients over a period of 3 years requesting implant removal after esthetic augmentation mammoplasty at the authors' department. All patients were treated according to their specific demands regarding breast shape after implant removal. They either received additional mastopexy, lipofilling or both or simple implant removal without further intervention. Demographic, implant-specific, perioperative and postoperative data have been evaluated for all patients. Additionally, all patients were asked to complete a questionnaire regarding satisfaction and outcome.
We observed a trend for more satisfied patients with less invasive procedures (simple implant removal or simultaneous lipofilling vs. explantation and mastopexy ± lipofilling, 1.8 vs. 2.0 or 2.6, p = 0.198). Patients' average scoring was better if they suffered from an implant rupture (1.55 vs. 2.17, p = 0.053). Overall, a high patient satisfaction has been observed for all procedures.
Breast implant carriers can suffer from problems and pathologies making implant removal the best solution. Exactly these patients, consulting their doctor for those problems and questions seem to profit from implant removal. Simultaneous lipofilling and mastopexy of the breast are good options to nevertheless generate an esthetically pleasing result.
隆胸手术目前是全球领先的美容外科手术。因此，有大量植入乳房假体的女性需要关于长期并发症管理的专业知识和技能。乳房假体携带者可能会出现问题和病变，这使得取出假体成为最佳解决方案。本文作者也越来越多地遇到被称为乳房植入物疾病（BID）或乳房植入物病症（BII）的不明症状复合体。BID的首选治疗方法是取出假体。
分析假体取出的问题和解决方案。根据患者的乳房和身体形态进行具体的患者分析。手术和术前规划的技术考量。评估作者的技术。
对作者所在科室3年内要求在美容隆乳术后取出假体的所有患者进行评估。所有患者均根据取出假体后对乳房形状的具体要求进行治疗。他们要么接受额外的乳房上提术、脂肪填充术或两者兼施，要么单纯取出假体而不进行进一步干预。对所有患者的人口统计学、假体相关、围手术期和术后数据进行了评估。此外，所有患者都被要求填写一份关于满意度和结果的问卷。
我们观察到一种趋势，即侵入性较小的手术（单纯取出假体或同时进行脂肪填充与取出假体并乳房上提术±脂肪填充相比）患者满意度更高（分别为1.8与2.0或2.6，p = 0.198）。如果患者的假体发生破裂，其平均评分会更好（1.55与2.17，p = 0.053）。总体而言，所有手术的患者满意度都很高。
乳房假体携带者可能会出现问题和病变，这使得取出假体成为最佳解决方案。正是这些因这些问题咨询医生的患者似乎从假体取出中受益。同时进行乳房脂肪填充和上提术是产生美观效果的良好选择。
