Gruber R P, Jones H W
Ann Plast Surg. 1981 Apr;6(4):271-6. doi: 10.1097/00000637-198104000-00003.
Seventy-five closed capsulotomies were reviewed and the degree of capsular contracture graded. The nutcracker technique was employed. In 35 cases, tonometric measurements before and after capsulotomy quantitated the improvement. Complications included inability to rupture the capsule, recurrence of contracture, distortion of breast shape, and in 1 patient, implant rupture. The degree of breast softness after capsulotomy correlated well with tonometry and was inversely proportional to the degree of preexisting capsular contracture. Softness was also proportional to the latency of onset of contracture. Analysis of the results suggests that capsulotomy is best performed in the patient with mild to moderate contracture and is containdicated in patients with severe contracture or breast distortion from previous capsulotomy. The nutcracker technique is advised, and reduction of pressure is urged once the capsular tear is heard. Closed capsulotomy usually, but not always improves breast firmness. It provides the physician with a nonoperative means of coping with an undesirable result.
回顾了75例闭合性囊切开术，并对囊挛缩程度进行分级。采用了胡桃夹技术。35例中，囊切开术前和术后的眼压测量定量了改善情况。并发症包括无法破裂囊膜、挛缩复发、乳房形状变形，以及1例患者出现植入物破裂。囊切开术后乳房柔软度与眼压测量结果相关性良好，且与术前存在的囊挛缩程度成反比。柔软度也与挛缩发生的潜伏期成正比。结果分析表明，囊切开术最好在轻度至中度挛缩的患者中进行，而在严重挛缩或因先前囊切开术导致乳房变形的患者中则为禁忌。建议采用胡桃夹技术，一旦听到囊膜撕裂声，应立即降低压力。闭合性囊切开术通常但并非总是能改善乳房硬度。它为医生提供了一种应对不良结果的非手术方法。
