Seckel B R, Costas P D
Department of Plastic and Reconstructive Surgery, Lahey Clinic Medical Center, Burlington, MA 01805.
Ann Plast Surg. 1993 Apr;30(4):296-301; discussion 301-3. doi: 10.1097/00000637-199304000-00002.
The use of intraluminal steroids in double-lumen breast implants is effective in preventing fibrous capsular contraction around the implant. This technique has not been accepted widely, however, and remains controversial primarily because steroid-related complications, including extrusion, late inferior migration, and atrophy of the skin, have been associated with their use. This nonrandomized retrospective study of 76 patients (146 breasts) who underwent submuscular augmentation of the breast through inframammary and periareolar incisions compares results after total musculofascial coverage of the implant with partial muscle coverage of the implant. In patients with partial muscle coverage of the implant, 7.8% steroid-related complications were observed. In the group with total musculofascial coverage of the implant, no steroid-related complications and no symptomatic contractions of the capsule were observed. Our study suggests that total musculofascial coverage provides a statistically significant margin of protection from steroid-related complications compared with techniques using only partial muscle coverage of the implant in patients who underwent cosmetic augmentation mammaplasty.
在双腔乳房植入物中使用腔内类固醇可有效预防植入物周围的纤维包膜挛缩。然而,该技术尚未被广泛接受,并且仍然存在争议,主要是因为与类固醇相关的并发症,包括挤出、晚期向下移位和皮肤萎缩,都与它们的使用有关。这项对76例患者(146个乳房)进行的非随机回顾性研究,这些患者通过乳房下和乳晕周围切口进行了乳房肌下隆乳术,比较了植入物完全肌筋膜覆盖与部分肌肉覆盖后的结果。在植入物部分肌肉覆盖的患者中,观察到7.8%的类固醇相关并发症。在植入物完全肌筋膜覆盖的组中,未观察到类固醇相关并发症和包膜的症状性挛缩。我们的研究表明,与在接受美容隆乳术的患者中仅使用部分肌肉覆盖植入物的技术相比,完全肌筋膜覆盖在预防类固醇相关并发症方面提供了具有统计学意义的保护优势。