Mladick R A
Center for Cosmetic Plastic Surgery, Virginia Beach, VA 23454.
Aesthetic Plast Surg. 1993 Summer;17(3):183-92. doi: 10.1007/BF00636260.
This article represents a retrospective view of the author's 17-year experience with 2863 saline implants in 1327 patients and details his "no-touch" technique. The experience included almost an equal number of submammary and subpectoral procedures. The submammary procedures were done early on and were replaced with subpectoral procedures, done exclusively at the present time. There were significantly less complications--capsules, wrinkling (visible folds), and deflations--with the subpectoral procedures. Followup is longer for submammary procedures which could be the reason for the slight difference in number of deflations. Analyzing the results from three different periods, during which the technique changed, the last period in which the no-touch subpectoral technique was used had markedly fewer complications. The no-touch technique, which had been introduced in orthopedic surgery over 50 years ago, was added to the augmentation procedure in an attempt to eliminate any possible contact with skin or breast bacteria. There were no infections in the entire series, and, during the no-touch period, capsules were almost eliminated (0.6%). Saline implants can achieve excellent results when placed subpectorally using the no-touch technique.
本文回顾了作者17年来对1327例患者植入2863个生理盐水乳房假体的经验,并详细介绍了他的“无接触”技术。该经验中,乳房下植入和胸大肌下植入手术的数量几乎相等。乳房下植入手术开展得较早,后来被胸大肌下植入手术取代,目前仅进行胸大肌下植入手术。胸大肌下植入手术的并发症(包膜挛缩、起皱(可见褶皱)和假体瘪陷)明显更少。乳房下植入手术的随访时间更长,这可能是假体瘪陷数量略有差异的原因。分析技术发生变化的三个不同时期的结果,使用无接触胸大肌下技术的最后一个时期并发症明显更少。50多年前在整形外科引入的无接触技术被应用于隆胸手术,以避免与皮肤或乳腺细菌的任何可能接触。整个系列中无感染病例,在无接触时期,包膜挛缩几乎消除(0.6%)。使用无接触技术将生理盐水乳房假体植入胸大肌下可取得极佳效果。