硅凝胶假体隆乳术后纤维包膜挛缩的预防

Prevention of fibrous capsule contraction after implant breast augmentation

目的:探讨预防和降低假体隆乳术后包膜挛缩的方法。方法:回顾分析151例(其中10例假体置换)采取预防包膜挛缩综合措施的隆乳就医者包膜挛缩发生的情况。对151例隆乳术者,笔者采用了以下几种方法:①适当扩大剥离的腔穴,一般较之假体直径大约2～4cm;②术中确炎舒松A囊腔局部浸润处理;③术后应用负压引流;④术后口服维生素E滴丸;⑤术后按摩及进行自身有节奏的运动。结果:术后随访0.5～2年,第一次隆乳的141例就医者中,136例患者乳房外观自然,挺拔逼真,手感柔软;5例就医者出现包膜挛缩(Baker分级:3例Ⅲ级,2例Ⅱ级)。10例假体置换就医者7例乳房外观自然,挺拔逼真,手感柔软;3例就医者再次出现包膜挛缩(Baker分级:1例l l I级,2例Ⅱ级)。结论:采取选择高质量假体、术中确炎舒松A囊腔局部浸润处理、术后引流和口服维生素E滴丸、术后坚持按摩及适当的运动等综合措施可以预防和降低包膜挛缩的发生。

Objective To explore the methods of preventingfibrous capsule contraction after breast augmentation. Methods A retrospective study analysised 151 cases applyed for methods of prevention fibrous capsule contraction afterimplant breast augmentation.In 151 cases,the author put forward several methods as follow： （1） enlarging the volume of cavity （3-4cm larger than prosthesis）. （2） Ttiamcinoloni Acetonidi Acetas inject. （3） application of negative-pressure drainage. （4）taking Vitamin E after breast augmentation. （5）massage and patients＇s self-rhythmic motion after breast augmentation. Results Follow up of 151 cases for 6 to 24 months.The results showed that the breast＇s shape and lexture of 136 in 141 cases have been more nature and smooth and no capsule contracture except 5 cases occurrencing capsule contracture;The results showed that the breast＇s shape and lexture of 7 in 10 cases have been more nature and smooth and no capsule contracture except 3 cases occurrencing capsule contracture. Conclusion We think that our methods mentioned above are improved to be effective to prevent less possibility of capsular contracture.