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囊前间隙重新定位:一种矫正隆乳修复术中植入物位置不当的有效技术。

Precapsular Pocket Repositioning: An Effective Technique for Correcting Implant Malposition in Revision Breast Augmentation.

作者信息

Qiao Chongxu, Shi Zai, Xu Jingyi, Miao Junyan, Yan Kaili, Yan Shunchao, Qu Yuming, Wu Guoping

机构信息

Department of Plastic Surgery, The Affiliated Friendship Plastic Surgery Hospital of Nanjing Medical University, Nanjing, 210029, Jiangsu Province, China.

出版信息

Aesthetic Plast Surg. 2025 Jun 4. doi: 10.1007/s00266-025-04964-z.


DOI:10.1007/s00266-025-04964-z
PMID:40468049
Abstract

BACKGROUND: Breast augmentation remains one of the most commonly performed cosmetic procedures worldwide. However, the reoperation rate following mammoplasty reaches up to 36%, with implant malposition being a major cause of revision surgery. Implant displacement from its intended position often necessitates corrective intervention to restore aesthetic balance. Surgical correction typically involves modifying the existing pocket or creating a new one. Despite advancements in various techniques, challenges remain in ensuring reliability, precision, and surgical simplicity. This study evaluates the use of the precapsular space to create a new pocket for correcting implant malposition. METHODS: Between December 2015 and August 2024, 29 patients (52 breasts) underwent revision breast augmentation utilizing the precapsular implant repositioning technique. All patients had previously undergone breast augmentation with implants and subsequently developed implant malposition. A neoprecapsular pocket was created above the anterior capsule wall to ensure precise implant positioning. Surgical outcomes were assessed based on symptom resolution, patient satisfaction, and postoperative complications. Clinical outcomes and patient-reported satisfaction were measured using BREAST-Q scores. RESULTS: The mean patient age was 28.8 years (range: 25-37), with an average follow-up of 7.9 months. Implant malposition was successfully corrected in all cases without postoperative complications, including capsular contracture, breast asymmetry, and symmastia. BREAST-Q results demonstrated high patient satisfaction, with significant improvements in breast appearance and symmetry achieved without an increased risk of complications. CONCLUSIONS: The precapsular pocket technique offers an effective solution for correcting implant malposition following breast augmentation. This method provides favorable aesthetic outcomes with high patient satisfaction and minimal complications, making it a promising approach for revision breast surgery. 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:隆胸仍是全球最常开展的美容手术之一。然而,乳房成形术后的再次手术率高达36%,植入物位置异常是修复手术的主要原因。植入物从预期位置移位通常需要进行矫正干预以恢复美学平衡。手术矫正通常包括修改现有的腔隙或创建一个新的腔隙。尽管各种技术有所进步,但在确保可靠性、精确性和手术简便性方面仍存在挑战。本研究评估利用囊前间隙创建新腔隙以矫正植入物位置异常的应用情况。 方法:2015年12月至2024年8月期间,29例患者(52侧乳房)采用囊前植入物重新定位技术接受了隆胸修复手术。所有患者此前均接受过植入物隆胸手术,随后出现了植入物位置异常。在前囊壁上方创建一个新的囊前腔隙以确保植入物精确就位。根据症状缓解情况、患者满意度和术后并发症评估手术效果。使用BREAST-Q评分衡量临床结果和患者报告的满意度。 结果:患者平均年龄为28.8岁(范围:25 - 37岁),平均随访7.9个月。所有病例的植入物位置异常均成功矫正,无术后并发症,包括包膜挛缩、乳房不对称和乳房融合。BREAST-Q结果显示患者满意度高,乳房外观和对称性显著改善,且并发症风险未增加。 结论:囊前腔隙技术为矫正隆胸术后植入物位置异常提供了一种有效的解决方案。该方法具有良好的美学效果,患者满意度高,并发症少,是一种有前景的隆胸修复手术方法。 证据等级IV:本刊要求作者为每篇文章指定证据等级。有关这些循证医学评级的完整描述,请参阅目录或作者在线指南www.springer.com/00266 。

相似文献

[1]
Precapsular Pocket Repositioning: An Effective Technique for Correcting Implant Malposition in Revision Breast Augmentation.

Aesthetic Plast Surg. 2025-6-4

[2]
Maximizing the use of precapsular space and the choice of implant type in breast augmentation mammaplasty revisions: review of 49 consecutive procedures and patient satisfaction assessment.

Aesthetic Plast Surg. 2011-4-1

[3]
The Use of "Precapsular Space" in Secondary Breast Reconstruction.

Aesthetic Plast Surg. 2016-10

[4]
Reoperative Augmentation Mammoplasty: An Algorithm to Optimize Soft-Tissue Support, Pocket Control, and Smooth Implant Stability with Composite Reverse Inferior Muscle Sling (CRIMS) and its Technical Variations.

Aesthetic Plast Surg. 2022-6

[5]
Subpectoral and precapsular implant repositioning technique: correction of capsular contracture and implant malposition.

Aesthetic Plast Surg. 2011-4-22

[6]
One-Stage Mastopexy-Lipofilling after Implant Removal in Cosmetic Breast Surgery.

Aesthetic Plast Surg. 2022-8

[7]
Optimizing Surgical Outcomes with Small-Volume Silicone Implants Associated with Autogenous Fat Grafting in Primary and Revision Breast Augmentation Surgery: Soft Weight Hybrid (SWEH) Concept.

Aesthetic Plast Surg. 2022-6

[8]
The capsular hammock flap for correction of breast implant ptosis.

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[9]
Breast Auto-augmentation (Mastopexy and Lipofilling): An Option for Quitting Breast Implants.

Aesthetic Plast Surg. 2019-5-7

[10]
Difficulties with subpectoral augmentation mammaplasty and its correction: the role of subglandular site change in revision aesthetic breast surgery.

Plast Reconstr Surg. 2010-1

本文引用的文献

[1]
History of breast implants: Back to the future.

JPRAS Open. 2022-3-11

[2]
Revision Breast Augmentation.

Semin Plast Surg. 2021-5

[3]
Popcorn Capsulorrhaphy in Revision Aesthetic Breast Surgery.

Aesthet Surg J. 2020-1-1

[4]
Risk Factor Analysis for Capsular Contracture, Malposition, and Late Seroma in Subjects Receiving Natrelle 410 Form-Stable Silicone Breast Implants.

Plast Reconstr Surg. 2017-1

[5]
Secondary Breast Augmentation.

Plast Reconstr Surg. 2016-7

[6]
Techniques to Repair Implant Malposition after Breast Augmentation: A Review.

Aesthet Surg J. 2016-6

[7]
Outcomes in primary breast augmentation: a single surgeon's review of 1539 consecutive cases.

Plast Reconstr Surg. 2015-1

[8]
Thermal capsulorrhaphy: a modified technique for breast pocket revision.

Aesthet Surg J. 2014-9

[9]
Shoelace Breast Cast.

Aesthet Surg J. 2014-7

[10]
Breast augmentation.

Plast Reconstr Surg. 2012-10

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