Price C I, Eaves F F, Nahai F, Jones G, Bostwick J
Department of Surgery, Emory University, Atlanta, Ga.
Plast Reconstr Surg. 1994 Oct;94(5):612-9. doi: 10.1097/00006534-199410000-00007.
The transaxillary approach to breast augmentation is an established technique that offers the advantage of a remote incision in an aesthetically acceptable area. The main disadvantage to this approach is the lack of visualization of the implant pocket, necessitating blind, blunt dissection of the pectoral muscle origins. Occasionally, this limitation may result in improper implant placement and poor aesthetic results. In order to address this shortcoming, we have explored the use of minimally invasive endoscopic techniques in transaxillary augmentation to allow division of the pectoral muscle origin under direct visualization, effectively lowering the inframammary crease. Initial dissections and instrument development were performed in five unpreserved female cadavers. Subsequently, 103 implants have been placed in 53 patients utilizing the endoscopic transaxillary approach. Follow-up ranges from 2 weeks to 20 months. There have been no hematomas, infections, capsular contractures, or other complications. Aesthetic results have been good, and patient acceptance is high. By providing predictable and reproducible control of the inframammary crease, endoscopic dissection has allowed us to expand our indications for the transaxillary approach to breast augmentation. Surgical technique and brief clinical experience are described.
经腋窝入路隆乳术是一种成熟的技术，其优点是在美学上可接受的区域有一个隐蔽的切口。该入路的主要缺点是无法可视化植入腔隙，需要盲目钝性分离胸肌起点。偶尔，这种局限性可能导致植入物放置不当和美学效果不佳。为了解决这一缺点，我们探索了在经腋窝隆乳术中使用微创内镜技术，以便在直视下分离胸肌起点，有效降低乳房下皱襞。最初在5具未防腐的女性尸体上进行了解剖和器械研发。随后，采用内镜经腋窝入路为53例患者植入了103枚植入物。随访时间为2周至20个月。未出现血肿、感染、包膜挛缩或其他并发症。美学效果良好，患者接受度高。通过对乳房下皱襞进行可预测和可重复的控制，内镜下分离使我们能够扩大经腋窝入路隆乳术的适应症。本文描述了手术技术和简要的临床经验。
