超高位双平面(三平面)假体隆乳术的疗效观察和优势分析  

An Analysis of the Effi cacy and Advantages of Ultra-high Dual-plane Techniques(Triple-Plane Techniques)for Breast Augmentation

作　　者：吕京陵 庄庆元 李长江 林军 王贺红 彭海峰 喻文悦 魏小雨 李帅 LYU Jingling;ZHUANG Qingyuan;LI Changjiang;LIN Jun;WANG Hehong;PENG Haifeng;YU Wenyue;WEI Xiaoyu;LI Shuai(Department of Plastic Surgery,Wuhu Hospital Affi liated to East China Normal University,Wuhu 241001,Anhui,China;Shanghai Yuemu Jiarong Medical Beauty Clinic,Shanghai 200001,China)

机构地区：[1]华东师范大学附属芜湖医院整形外科,安徽芜湖241001 [2]上海悦目佳容医疗美容门诊部,上海200001

出　　处：《中国美容医学》2024年第6期5-9,共5页Chinese Journal of Aesthetic Medicine

摘　　要：目的:分析超高位双平面假体隆乳术的临床结果,探讨更适合亚洲人的假体隆乳术方式。方法:选取2019年8月-2022年8月笔者医院接受假体隆乳术的289例就医者进行回顾性分析,年龄18~56岁,平均35.7岁,采用改良后的双平面技术,在乳头乳晕水平全层横向离断胸大肌,断端分别向上向下回缩,形成上下两个袋状肌瓣,上瓣覆盖了假体上极,下瓣将假体装入袋中,肌肉断端回缩后的乳头乳晕位置假体覆盖为乳腺筋膜后。结果:术后随访13~36个月,平均随访19个月。超高位切断胸大肌后,向上回缩的肌瓣覆盖假体上极,减少假体边缘感和皮肤皱褶;向下回缩的袋状肌瓣将假体装入袋中,既改善乳房下极的丰盈度,减轻假体的触及感,又提高假体的稳定性。另外,超高位切断的胸大肌,保留运动神经支配上部肌瓣收缩时,肌肉呈水平矢量收缩,使假体向下运动最小化;而失去神经支配的下部肌瓣抵消胸肌收缩对假体产生向下的压力,有效地减少动态畸形和双泡畸形。所有患者乳房外形美感佳,手感柔软逼真,假体边界不明显,乳房活动度正常,就医者满意度高。结论:超高位双平面假体隆乳术是一项可靠的技术,可以给假体提供良好的组织覆盖和自然、持久的效果,减少了传统双平面的不足和缺陷,是更适合亚洲人的假体隆乳手术。Objective To analyze the clinical results of breast augmentation surgery with ultra-high dual-plane implants and explore more suitable methods for breast augmentation in Asians.Methods A total of 289 patients,aged 18-56 years with an average age of 35.7 years,who underwent breast augmentation with prostheses between August 2019 and August 2022 were selected.The modified dual-plane technique was used to horizontally dissect the pectoralis major muscle at the nipple and areola,with the broken ends retracting upwards and downwards to form two baggy muscleflaps.The upperflap covered the upper pole of the prosthesis,while the lowerflap placed the prosthesis in a bag,The nipple and areola position after the retraction of the broken muscle end is covered with a prosthesis behind the breast fascia.Results The postoperative follow-up was 13-36 months,with an average follow-up of 19 months.After cutting the pectoralis major muscle at an ultra-high position,the retracted muscleflap covers the upper pole of the prosthesis,reducing the sense of edge and skin wrinkles of the prosthesis.The retracted pouch-shaped muscle flap packs the prosthesis into the bag,improving the fullness of the lower breast pole,reducing the tactile sensation of the prosthesis,and improving its stability.In addition,when the pectoralis major muscle is cut offat a super high position and retains the motor nerve innervation for the contraction of the upper muscleflap,the muscle contracts in a horizontal vector,minimizing the downward movement of the prosthesis.The lower muscleflap,which loses its innervation,counteracts the downward pressure generated by chest muscle contraction on the prosthesis,effectively reducing animation deformities and double bubble deformities.All patients had good aesthetic breast shape,soft and realistic feeling,no obvious boundary of the prosthesis,normal breast mobility,and high satisfaction of patients.Conclusion The improved ultra-high biplane breast augmentation technique can provide good tissue coverage and natura

关 键 词：双平面假体隆乳术 超高位双平面 三平面 胸大肌瓣 组织覆盖 动态畸形 

分 类 号：R622[医药卫生—整形外科]