SEPS镜辅助下的乳房整形术:隆乳和注射隆乳异物清除

Applications of SEPS endoscope in mammaplasty: breast augmentation and removing breast foreign body resulted from augmentation with polyacrylamide hydrogel injection

目的直视下探查分离假体置入腔隙及聚丙烯酰胺水凝胶注射隆乳术后形成的多发性异物囊腔结节,减轻组织创伤,提高隆乳术效果和异物清除率。方法自2001年3月起在SEPS镜辅助下完成21例乳房整形术,其中13例为隆乳术,8例为聚丙烯酰胺水凝胶注射隆乳术后坚决要求行异物清除术,术前B超对异物定位标记,全部手术经腋部切口,在SEPS镜辅助下对皮下、乳腺内、腺体后、胸肌内等不同解剖层次的异物结节囊腔逐一探查剥离,清除异物,隆乳术者于胸大肌下剥离假体置入腔隙。结果术后无血肿、感染,伤口Ⅰ期愈合。随访6￣18个月,注射隆乳所致乳房疼痛、乳腺结节和双侧乳房不对称畸形等术前不良临床表现消失,术后复查乳腺B超已无异物包块征象;隆乳术后假体无移位,乳房外形及手感良好。结论SEPS镜辅助直视下行注射隆乳异物取出和隆乳较常规盲视下操作组织创伤小,更安全,确切,可靠,不失为注射隆乳异物清除和隆乳的良好方法。

[Objective] To relief the tissue injury during the implant pocket dissection and increase the clearance through excluding multiple breast cysts of foreign body resulted from augumentation with polyacrylamide hydragel injection under direct vision. [Method] Subfaseial Endoscopic Perforator Vein Surgery had been utilized in 21 cases of mammaplasty since 2001, which was applied to separate implant pocket and exclude the cysts distributed in the subcutaneous tissue, breast or existed in the muscles through a transaxillary approach. Preoperative B type ultrasound was essential for the operation to mark the mass in some cases. [Results] The operations were completed without hentotoma and infection. Follow-up of 21 patients for 6-18 months showed that preoperative symptoms relating to injected material in 8 cases, such as pain, breast mass and bilateral asymmetry have been no longer existed. Most of the patients who underwent this procedure were satisfied with their results. [Conclusion] We believe that endoscopic assisted mammoplasty offers more satisfactory clinical results with less morbidity, injury, smaller scars, more accuracy and greater patient acceptance. Transaxillary endoscopic mammaplasty is an attractive alternative technique.