内窥镜在下皱襞切口双平面光面假体隆乳中的应用  

The application of endoscope in dual plane breast augmentation with smooth implants through inframammary incision

作　　者：马静 杨大平 MA Jing;YANG Daping(Breast Plastic Surgery Center,Beijing First BCC Hospital,Beijing 100022,China)

机构地区：[1]北京联合丽格第一医疗美容医院乳房整形中心,北京市100022

出　　处：《组织工程与重建外科》2024年第3期312-317,共6页Journal of Tissue Engineering and Reconstructive Surgery

摘　　要：目的探讨内窥镜在下皱襞切口双平面光面假体隆乳中应用的可行性、安全性及有效性。方法下皱襞切口隆乳术中,在剥离胸大肌后间隙时置入内窥镜,可视化下进行腔隙的精准剥离、确切止血,可减少组织损伤。对手术时间、住院时间、引流情况、舒适度、并发症、术后效果、满意率等进行分析。结果本组共108例患者,均采用全身麻醉,均使用光面假体,均采用双平面技术。38例选择曼托假体,48例选择娜绮丽假体,14例选择星熠假体,8例选择伊思雅假体。假体大小220~350 cc。1型双平面98例(90.7%),2型双平面8例(7.4%),3型双平面2例(1.9%)。平均手术时间72 min,平均住院2 d。放置引流患者30例(27.8%),未放置引流患者78例(72.2%)。2个乳房(0.9%)出现血肿,1个乳房(0.5%)出现Ⅲ级包膜挛缩,2个乳房(0.9%)出现假体移位,3个乳房(1.4%)术后瘢痕明显。术后镇痛者18例(16.7%),未镇痛者90例(83.3%)。术前乳头到下皱襞距离为(5.80±0.43)cm,术后为(8.05±0.33)cm,差异显著(P<0.05)。达到患者预期并对大小、形态、手感等非常满意的有88例(81.5%),满意15例(13.9%),满意率95.4%。结论在下皱襞切口中应用内窥镜进行双平面光面假体隆乳效果良好,满意率较高,并发症较少,是可行并安全、有效的。Objective To investigate the feasibility,safety and efficacy of application of endoscope in dual plane breast augmentation with smooth implants through inframammary incision.Methods When dissecting the posterior space of the pectoralis during breast augmentation through the inframammary incision,an endoscope was inserted to visualize the precise dissection and hemostasis of the space,reducing tissue trauma.The operation time,hospital stay,drainage situation,comfort,complications,postoperative effects and satisfaction rate were analyzed.Results A total of 108 patients were treated with general anesthesia,smooth implants,and dual plane technique.Thirty-eight patients chose Mentor implants,forty-eight patients chose Natrelle implants,fourteen patients chose Mentor extra implants,and eight patients chose ES implants.The size of the implants ranged from 220 cc to 350 cc.Ninety-eight patients(90.7%)underwent type 1 dual plane,eight patients(7.4%)underwent type 2 dual plane and two patients(1.9%)underwent type 3 dual plane.The average operation time was 72 minutes,the average hospitalization was 2 days.Thirty patients(27.8%)used drainages.Seventy-eight cases(72.2%)did not use drainages.Two breasts(0.9%)experienced hematoma.One breast(0.5%)experienced gradeⅢcapsular contracture.Two breasts(0.9%)experienced displacement of implants.Three breasts(1.9%)experienced obvious scar.Eighteen cases(16.7%)received postoperative pain relief,while ninety cases(83.3%)did not receive pain relief.The distance from nipple to the inframammary fold was(5.80±0.43)cm before surgery and(8.05±0.33)cm after surgery,the difference was significant(P<0.05).Eighty-eight cases(81.5%)met the patient's expectations and were very satisfied with the size,shape,feel,etc.Fifteen cases(13.9%)were satisfied.The satisfaction rate was 95.4%.Conclusion The application of endoscope in dual plane breast augmentation with smooth implants through inframammary incision has a good effect,high satisfaction rate,and fewer complications.It is feasible,safe,and effe

关 键 词：内窥镜 下皱襞切口 双平面 光面假体 隆乳 

分 类 号：R622[医药卫生—整形外科]