腹直肌肌瓣乳房下皱襞重建在聚丙烯酰胺水凝胶取出同期隆乳术中的应用  

Application of submammary fold reconstruction with rectus abdominis flap on the primary augmentation mammoplasty after removing injected polyacrylamide hydrogel

作　　者：任丽虹[1] 杨大平[1] 马旭[1] 李宁[1] 刘莺[1] 

机构地区：[1]哈尔滨医科大学附属第二医院整形美容科,黑龙江哈尔滨150086

出　　处：《中国美容整形外科杂志》2013年第8期466-468,共3页Chinese Journal of Aesthetic and Plastic Surgery

摘　　要：目的 探讨在聚丙烯酰胺水凝胶取出后,出现乳房下皱襞消失并Ⅰ期置入硅胶假体的患者中,应用腹直肌肌瓣行乳房下皱襞重建术的临床治疗效果.方法 共16例聚丙烯酰胺水凝胶注射隆乳后出现注射物移位,取出后乳房下皱襞消失;其中11例双侧,5例单侧,同期行硅胶假体隆乳术.手术在局部麻醉或全身麻醉下进行,取乳房下皱襞切口长5～8cm,取出注射物,置入硅胶乳房假体,闭合乳房下皱襞下方异常腔隙,制成3cm×5cm～3cm×7cm腹直肌肌瓣,并向上翻转与乳房下极固定,重建乳房下皱襞结构.结果 所有患者切口愈合良好,除1例单侧再次出现注射物的移位行局部抽吸术外,其余15例均拥有正常的乳房下皱襞形态,双侧乳房对称,外观大小满意,手感好.结论 注射物取出同期假体置入,需严格控制在适应证内进行;同期重建乳房及下皱襞形态,可取得良好的效果,且可免除患者二次手术的痛苦.Objective To explore the effect of submammary fold reconstruction with rectus abdominis flap after removing injected polyacrylamide hydrogel （PAAG） in patients, whose submammary folds had disappeared. Methods The submammary folds in 16 cases disappeared after removing displaced PAAG, 11 cases were with bilateral and 5 cases with unilateral displacement. Augmentation mammoplasty with silicone gel prosthesis was performed simultaneously. Under the local or general anesthesia, the injected PAAG was removed through the 5-8 cm incision on the submammary fold and then the prosthesis was implanted, abnormal interspaces were closed and suhmammary fold was reconstructed by rotating upward 3 cm ×5 cm to 3 cm× 7 cm rectus abdominis flap and fixing it to the mammary bottom. Results The submammary folds were successfully created in all cases except for one case involving the reoccurrence of PAAG, which was treated by local suction. The shape and size of the breasts were all symmetrical and satisfied. Conclusion The primary augmentation mammoplasty with silica gel prosthesis after removing injected PAAG should be performed following the indications carefully, primary reconstruction of the breast and its shape could be obtained which avoid suffering a secondary operation.

关 键 词：聚丙烯酰胺水凝胶 隆乳术 硅胶乳房假体 乳房下皱襞 

分 类 号：R655.8[医药卫生—外科学]