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光面圆形假体双平面隆乳术后乳房形态变化的影响因素:一项相关性研究

The Influencing Factors of Breast Morphological Changes After Dual-Plane Augmentation with Smooth Round Implans: A Correlational Study.

作者信息

Liu Yue, Zhang Xiaoyu, Luan Jie

机构信息

Department of Aesthetic and Reconstructive Breast Surgery, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No.33 Badachu Road, Shijingshan District, Beijing, 100144, China.

出版信息

Aesthetic Plast Surg. 2025 Apr;49(7):1973-1987. doi: 10.1007/s00266-024-04605-x. Epub 2024 Dec 16.

DOI:10.1007/s00266-024-04605-x
PMID:39681691
Abstract

BACKGROUND

Breast morphology is the primary objective indicator for evaluating the outcome of augmentation surgery. Studies have indicated that breast morphology undergoes certain changes during the early postoperative period, which may result in a discrepancy between postoperative outcomes and preoperative design. This study utilized three-dimensional scanning technology and statistical methods to analyze the influencing factors of breast morphology changes, aiming to provide reference for implant selection and preoperative surgical planning.

METHODS

The study included patients who underwent endoscopic-assisted transaxillary dual-plane augmentation from July 2020 to June 2022. Anthropometry and three-dimensional scanning were performed on the enrolled patients, and the change values of postoperative breast morphological parameters were calculated. Spearman rank correlation tests were performed to assess the correlation between these changes and implant parameters as well as anthropometric measurements. Factors with high correlation were selected, and multivariate linear regression analysis was conducted.

RESULTS

A total of 30 patients (60 breasts) were enrolled. The average downward displacement of the inframammary fold was 0.4 ± 0.3 cm, and the average outward displacement of the medial breast border was 0.2 ± 0.1 cm, both highly positively correlated with implant volume. The length of nipple-medial breast border increased by 0.5 ± 0.3 cm, highly positively correlated with the stretchability of the medial pole. The length of the nipple-to-inframammary fold increased by 0.6 ± 0.3 cm, highly positively correlated with implant volume and stretchability of the lower pole. Nipple displacement was 0.3 ± 0.2 cm outward, highly positively correlated with the stretchability of the medial pole. Nipple elevation was 0.2 ± 0.2 cm, highly positively correlated with implant volume and stretchability of the lower pole. Breast projection decreased by 0.4 ± 0.2 cm, highly positively correlated with preoperative breast projection. The average reduction in breast volume was 25.6 ± 15.7 cc, with the reduction value highly positively correlated with preoperative breast volume.

CONCLUSIONS

After smooth round implant augmentation mammoplasty, the breasts experienced slight downward and outward displacement, with the main influencing factor being the implant volume. Nipple displacement outward and upward, as well as lateral displacement, was primarily influenced by the stretchability of the medial pole. Upward displacement was mainly influenced by implant volume and the stretchability of the lower pole. The increase in length of the nipple-to-inframammary fold skin was most significantly influenced by implant volume and the stretchability of the lower pole. Breast convexity and volume gradually decreased, with preoperative breast size having the most significant impact on these changes.

LEVEL OF EVIDENCE IV

This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

摘要

背景

乳房形态是评估隆胸手术效果的主要客观指标。研究表明,乳房形态在术后早期会发生一定变化,这可能导致术后效果与术前设计存在差异。本研究利用三维扫描技术和统计方法分析乳房形态变化的影响因素,旨在为假体选择和术前手术规划提供参考。

方法

本研究纳入了2020年7月至2022年6月接受内镜辅助经腋窝双平面隆胸术的患者。对纳入患者进行人体测量和三维扫描,并计算术后乳房形态参数的变化值。进行Spearman等级相关检验,以评估这些变化与假体参数以及人体测量指标之间的相关性。选择相关性高的因素进行多元线性回归分析。

结果

共纳入30例患者(60侧乳房)。乳房下皱襞平均向下移位0.4±0.3厘米,乳房内侧边界平均向外移位0.2±0.1厘米,两者均与假体体积高度正相关。乳头至乳房内侧边界长度增加0.5±0.3厘米,与内侧乳房组织的延展性高度正相关。乳头至乳房下皱襞长度增加0.6±0.3厘米,与假体体积和下极的延展性高度正相关。乳头向外移位0.3±0.2厘米,与内侧乳房组织的延展性高度正相关。乳头抬高0.2±0.2厘米,与假体体积和下极的延展性高度正相关。乳房突度下降0.4±0.2厘米,与术前乳房突度高度正相关。乳房体积平均减少25.6±15.7立方厘米,减少值与术前乳房体积高度正相关。

结论

在植入光面圆形假体隆胸术后,乳房出现轻微的向下和向外移位,主要影响因素是假体体积。乳头向外和向上移位以及向外侧移位主要受内侧乳房组织延展性的影响。向上移位主要受假体体积和下极延展性的影响。乳头至乳房下皱襞皮肤长度增加最显著受假体体积和下极延展性的影响。乳房凸度和体积逐渐减小,术前乳房大小对这些变化影响最为显著。

证据级别IV:本刊要求作者为每篇文章指定一个证据级别。有关这些循证医学评级的完整描述,请参阅目录或在线作者指南www.springer.com/00266 。

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本文引用的文献

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