乳房下皱襞切口假体隆乳术的临床应用与要点剖析  

Clinical application and analysis of the key points of breast augmentation via inframammary fold incision

作　　者：李志斌 谢百慧 王喜梅[1] Li Zhibin;Xie Baihui;Wang Ximei(Department of Medical Plastic and Cosmetic Center,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China)

机构地区：[1]郑州大学第一附属医院医学美容中心,450052

出　　处：《中华整形外科杂志》2020年第11期1237-1241,共5页Chinese Journal of Plastic Surgery

摘　　要：目的探讨经乳房下皱襞切口行硅凝胶假体隆乳的技术要点及临床效果。方法2018年1月至2019年6月,郑州大学第一附属医院医学美容中心收治26例隆乳患者,年龄24~38岁,平均30.2岁,其中乳房发育不良患者10例,乳腺萎缩患者16例。术前根据患者身高、体质量、乳房测量数据及需求,预选假体的体积、类型,设计新乳房下皱襞位置;术中精确地剥离腔隙后,使用圆形扩张器注水再次评估,确定最终的假体体积,置入假体,重建乳房下皱襞;术后给予止痛泵镇痛、抗瘢痕综合治疗。术后对并发症、乳房形态、切口瘢痕以及患者对手术效果是否满意进行随访。结果26例患者手术过程顺利,手术时间38~45 min,引流时间3~4 d,单侧引流量30~50 ml,切口满意率96%(25/26)。术后随访8~16个月,平均12个月,无血肿、感染、包膜挛缩等并发症,乳房形态自然、挺拔、饱满,双侧对称,切口瘢痕不明显,位于新的乳房下皱襞处,患者对手术效果非常满意。结论经乳房下皱襞切口行硅凝胶假体隆乳术,操作路径短、可直视下精确剥离和止血、手术时间短,术中结合扩张器注水再次评估所需假体体积,重建了乳房下皱襞,术后并发症少,临床效果满意。Objective To explore the technical points and clinical effects of breast augmentation with silicone prosthesis through inframammary fold(IMF)incision.Methods From January 2018 to June 2019,26 cases of patients undergoing breast augmentation in our department were collected,including 10 cases of breast hypoplasia and 16 cases of breast atrophy,ranging in age from 24 to 38 years,with an average year of 30.2.The preselection of the volume,type of prosthesis and the design of new position of IMF were based on the height,weight,breast measurements and individual demand.During the operation,after precisely dissecting the lacunae,water were injected into the circular expander to reassess the volume of prosthesis,then the final prosthesis was implanted and the inframammary fold was reconstructed.After operation,patients were given analgesic pump and combined anti-cicatricial treatment.Postoperative complications,breast morphology,incision scar,and whether the patient was satisfied with the surgical evaluation were followed up.Results All operations were successful and the operative time ranged from 38 to 45 minutes,the drainage time was 3-4 days,the drainage volume of the unilateral space was 30-50 ml,96 percent of the patients(25/26)were satisfied with the incision.Postoperative following up lasted from 8 months to 16 months with an average of 12 months.No complications such as hematoma,infection or capsular contracture occurred.The breast shape of 26 patients after operation was natural,erect,plump and bilaterally symmetrical.The incision scar of new IMF was not conspicuous.The patients were very satisfied with the operation effect.Conclusions Breast augmentation through IMF incision has advantages of short operating path,accurate dissecting and hemostasis under direct vision,short operation time.During the operation,in combination with re-evaluation after the expander inflated with saline to the required prosthesis volume and reconstruction of IMF,satisfactory clinical effects can be achieved with fewer complications.

关 键 词：乳房植入物 组织扩张装置 隆乳术 乳房下皱襞切口 

分 类 号：R655.8[医药卫生—外科学]