经腋窝切口清除乳房内聚丙烯酰胺水凝胶同期硅凝胶假体置入术

Removal of PAMHG from breast through axillary incision and implantation of silica gel prosthesis at the same time

目的:探讨如何取净乳房内聚丙烯酰胺水凝胶(PAMHG)并维持相应的乳房形态。方法:自2004年至2007年笔者用经腋窝切口分离至乳房后间隙,清除PAMHG,并用抗生素生理盐水反复稀释冲洗。经确定冲洗液内已无注射材料残留后,于胸大肌深面剥离、假体置入腔隙,置入硅凝胶假体的方法共治疗108例。结果:已行108例216侧PAMHG取出并隆乳术,其中1例由于感染,清除PAMHG后,经抗炎治疗3个月后行假体置入术,术后随访3个月～3年。结论:经腋窝隐蔽切口能相对彻底清除PAMHG,并行胸大肌深面隆乳术,较好地维持相应的乳房形态。

Objective To investigate the method of removing PAMHG from breast and maintaining the ideal breast shape. Methods From 2004 to 2007, patients which breast were injected with PAMHG were dissected to the post-mammary space through axillary incison and PAMHG was cleaned up. The wound space was irrigated repeatedly by antibiotics saline water. After PAMHG was removed, the post-major pectoral muscle plane was dissected and silica gel prosthesis was implanted through the same incision. Results 216 breasts of 108 patients were treated by this operation（There was an exception that one patient took 3 months of anti-inflammatory therapy between removal of PAMHG and implantation）. The follow-up time was between 3 months to 3 years. The morphology of augmented breasts was excellent. Conclusion PAMHG could be cleaned up relatively through the occult axillary incision, and post-major pectoral muscle mammary augmentation with silica gel prosthesis at the same time could maintain the aesthetic appearance of breasts.