Seren Juan M, Cervantes Andre, Fontbona Montserrat, Cortinas Fabian, Abrile Gustavo, Mayer Horacio F
Department of Plastic Surgery, Sanatorio de la Trinidad Palermo, Buenos Aires, Argentina.
Department of Plastic Surgery, Hospital do Coracao, Sao Paulo, Brazil.
Aesthetic Plast Surg. 2025 Jan;49(1):198-204. doi: 10.1007/s00266-024-04231-7. Epub 2024 Jul 16.
Medical and technical advances have changed the state of postoperative surgical patient care, allowing for better and faster recovery. Since its publication, predictable 24-hour recovery in breast augmentation surgery has been controversial and has generated discussion. In this study, we present a novel, easy, and reproducible protocol for Enhanced Recovery After Breast Augmentation Surgery (ERABAS), along with a summary of the ten points to follow.
We conducted a retrospective study of all primary breast augmentation surgeries performed between 2010 and 2020 by a private activity. All surgeries were performed by the same surgeon according to the same protocol, and all implants were obtained from the same company. Data were evaluated using two binary logistic regression models, taking as variables responses to recovery time and postoperative pain and as predictor or explanatory variables to the factors age, smoking, size, and location of the implant.
In total, 2906 patients were included in this study. Of these, 2770 patients (95%) immediately returned to normal life within the first 24 h, 129 achieved normal life in four days, and only seven needed a week to recover. In these seven patients, the main acute complications were hemorrhage and acute hematoma. The implants were always round; textured implants were used in 88.8% of patients, while smooth implants were used in 11.2%. A subfascial pocket was used in 934 patients, and a dual-plane pocket was performed for 1972 patients. The only factor that showed a significant effect on recovery time was the location of the implant (p < 0.05), with the dual-plane pocket being the intervention associated with a later recovery, specifically a probability of recovery after 24 hour, 2.86 times greater than subfascial.
The ERABAS protocol allowed rapid return to daily activities with low complication rates. Further prospective comparative multicenter studies are required to confirm these results.
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医学和技术的进步改变了术后外科患者护理的状况，使恢复更好、更快。自发表以来，隆胸手术中可预测的24小时恢复情况一直存在争议并引发了讨论。在本研究中，我们提出了一种新颖、简便且可重复的隆胸手术后加速康复方案（ERABAS），以及十点注意事项总结。
我们对2010年至2020年间由一家私立机构进行的所有初次隆胸手术进行了回顾性研究。所有手术均由同一位外科医生按照相同方案进行，所有植入物均来自同一家公司。使用两个二元逻辑回归模型对数据进行评估，将恢复时间和术后疼痛的反应作为变量，将年龄、吸烟、植入物大小和位置等因素作为预测或解释变量。
本研究共纳入2906例患者。其中，2770例患者（95%）在术后24小时内立即恢复正常生活，129例在四天内恢复正常生活，只有7例需要一周时间恢复。在这7例患者中，主要的急性并发症是出血和急性血肿。植入物均为圆形；88.8%的患者使用了表面有纹理的植入物，11.2%的患者使用了光滑植入物。934例患者采用了筋膜下间隙植入，1972例患者采用了双平面间隙植入。唯一对恢复时间有显著影响的因素是植入物的位置（p < 0.05），双平面间隙植入是与恢复较晚相关的干预措施，具体而言，术后24小时恢复的概率比筋膜下间隙植入高2.86倍。
ERABAS方案使患者能够快速恢复日常活动，且并发症发生率较低。需要进一步开展前瞻性比较多中心研究来证实这些结果。
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