聚丙烯酰胺水凝胶注射隆鼻和隆乳并发症的处理

Suitable treatment for the complications induced by polyacrylamide hydrogel injection for augmentation mammoplasty and augmentation rhinoplasty

目的:探讨聚丙烯酰胺水凝胶(PAHG)注射隆鼻和隆乳并发症的处理策略。方法:对注射PAHG隆鼻19例,注射隆乳58例术后并发症就医者的临床资料及诊治方法进行总结分析,其中6例同期植入鼻假体,3例同期植入乳房假体。结果:注射隆鼻取出术后,切口Ⅰ期愈合好,同期植入鼻假体就医者的鼻部外形满意,术后随访3～15月,局部无红肿,假体无晃动及外露;注射隆乳取出术后,有3例切口延迟愈合,其余Ⅰ期愈合良好,术后一年内随访,乳房未触及明显硬结。同期植入就医者的乳房形态好,乳房外形及手感均感满意。结论:在MRI扫描照片引导,手术直视下清除PAHG及切除变性组织,才是最大限度地取出PAHG的方法。在就医者有强烈要求且术中清除较彻底,局部组织较为完整的前提下可考虑同期行假体植入。否则取出至少3个月后重新评价局部情况,判断是否行假体植入。

Obejective To analyze the clinical manifestation and explore suitable treatment for the complications induced by PAHG injection for augmentation mammoplasty and augmentation rhinoplasty. Methods The clinical data and treatment of 19 patients for augmentation rhinoplasty and 58 patients for augmentation mammoplasty with some complications induced by PAHG injection were analyzed, which included 6 patients implanted nose implant and 3 patients implanted breast implant. Results After the augmentation rhinoplasty;The incision healed well and the patients were satisfied with their nose features as well. After operation all the patients were followed-up for 3 to 15 months . Meanwhile,the noses didn＇t swelling and the nose implants didn＇t moved and were not rejected ; After the augmentation mammoplasty, 3 patients delayed to heal, but the other patients healed. All the patients were followed-up for 1 year, there was no obvious induration and both the brease shape and hand-feeling were satisfied. Conclusion Under the MRI scanning picture guidance,eliminate PAHG and excise the denaturation organization is the best way to take out polyacrylamide hydrogel maximum. Only the patients strongly require to eliminate PAHG thoroughly, or more local fiber node under the premise of integrity local fibrous structure are in their completed form,can phantom implanted at the same time be considered, otherwise, it will be judged according to the partial situation three months later.