Chung Kawun, Yang Huanzuo, Xie Yanyan, Liang Faqing, Feng Yu, Zhang Donglin, Du Zhenggui
Department of General Surgery, West China Hospital, Sichuan University, Chengdu Sichuan, 610041, P. R. China.
Breast Center, West China Hospital, Sichuan University, Chengdu Sichuan, 610041, P. R. China.
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2024 Jul 15;38(7):807-812. doi: 10.7507/1002-1892.202404032.
To explore the surgical technique and preliminary safety and aesthetic results of endoscopic removal of injectable Amazingel with/without immediate prepectoral implant-based breast augmentation for patients.
The clinical data of 25 patients who underwent endoscopic removal of injectable Amazingel with/without immediate prepectoral implant-based breast augmentation between April 2020 and January 2024 and met the selection criteria was retrospective analysed. The patients' age ranged from 33 to 73 years, with a mean of 50.4 years, and the body mass index ranged from 16.8 to 26.6 kg/m , with a mean of 21.5 kg/m . They were all bilaterally injected with Amazingel, and the time between initial injections and surgery ranged from 17 to 26 years, with a mean of 21.4 years. Early safety was evaluated by the incidence of early postoperative complications, and early aesthetic results were evaluated using Harris scores (including breast shape satisfaction, sensation satisfaction, and elasticity satisfaction) at 3 months after operation.
There were 9 cases underwent Amazingel removal (group A) and 16 cases underwent Amazingel removal with immediate prepectoral implant-based breast augmentation (group B). Intraoperative removal of Amazingel ranged from 808 to 1 285 mL, with a mean of 1 050.7 mL; the mass of the capsule removed ranged from 36 to 169 g, with a mean of 103.6 g; and a gross anatomical prosthesis was used with a median size of 345 mL (range, 315-355 mL). The operation time ranged from 95 to 395 minutes, with a mean of 194.2 minutes; and the cost of the procedure ranged from 8000to 91 000 yuan, with a mean of 33 000 yuan. Patients had a median follow-up time of 22.7 months (range, 3.0-48.1 months). There was 1 case of intraoperative skin burn due to the operation of the electric scalpel, which healed naturally after operation without flap necrosis. There was no adverse conditions such as prosthesis outline showing, ripple sign, and capsular contracture during follow-up; a small amount of Amazingel residue was found in 2 patients at 1 year after operation. The Harris score at 3 months after operation was used to evaluate the early aesthetic results, and the breast shape, elasticity, and sensation satisfaction of group A were lower than group B, but the differences between the two groups were not significant ( >0.05).
Endoscopic removal of injectable Amazingel with/without immediate prepectoral implant-based breast augmentation is safe in the early stage with good aesthetic results, and it is also recommended that patients who had the indications for combined immediate breast augmentation after removal to rebuild the breast appearance.
探讨采用内镜取出注射用奥美定并即刻行胸肌前乳房假体植入隆乳术或单纯内镜取出注射用奥美定的手术技巧及早期安全性和美学效果。
回顾性分析2020年4月至2024年1月期间25例接受内镜取出注射用奥美定并即刻行胸肌前乳房假体植入隆乳术或单纯内镜取出注射用奥美定且符合入选标准患者的临床资料。患者年龄33～73岁，平均50.4岁；体重指数16.8～26.6kg/m²，平均21.5kg/m²。均为双侧注射奥美定，初次注射至手术时间17～26年，平均21.4年。通过术后早期并发症发生率评估早期安全性，采用Harris评分（包括乳房形态满意度、感觉满意度和弹性满意度）于术后3个月评估早期美学效果。
单纯奥美定取出组（A组）9例，奥美定取出并即刻行胸肌前乳房假体植入隆乳术组（B组）16例。术中取出奥美定808～1285mL，平均1050.7mL；取出包膜质量36～169g，平均103.6g；使用毛面解剖型乳房假体，中位数大小为345mL（范围315～355mL）。手术时间95～395分钟，平均194.2分钟；手术费用8000～91000元，平均33000元。患者中位随访时间22.7个月（范围3.0～48.1个月）。术中发生1例电刀操作导致的皮肤烫伤，术后自然愈合，未发生皮瓣坏死。随访期间未出现假体轮廓显现、波纹征、包膜挛缩等不良情况；术后1年有2例患者发现少量奥美定残留。采用术后3个月Harris评分评估早期美学效果，A组乳房形态、弹性和感觉满意度低于B组，但两组差异无统计学意义（P>0.05）。
采用内镜取出注射用奥美定并即刻行胸肌前乳房假体植入隆乳术或单纯内镜取出注射用奥美定早期安全性良好，美学效果较好，对于取出后有即刻隆乳指征的患者，建议同期行乳房外观重塑。
