隆乳假体取出后的修复策略

Surgical management in breast explant removal operation

目的探讨假体隆乳术后,二期行假体取出术时的修复策略。方法回顾分析2017年1月~2020年6月,96例假体隆乳术后需行假体取出/调整术患者的手术方法及术后效果。基于患者手术目的,结合假体放置情况、乳房外形及容量,采用四种不同手术方法进行修复,包括假体取出、假体置换、假体取出+乳房固定、假体置换+乳房固定、假体取出+脂肪移植。结果5例行乳房固定术患者发生血清肿,持续引流后治愈;1例行乳房固定术患者发生切口部分裂开,清创缝合后治愈。随访6个月~3年,乳房形态饱满、轮廓自然,乳房上提固定效果良好持久,无乳头乳晕坏死、瘢痕增生、乳房下垂等并发症。患者对乳房外形均表示满意。结论对隆乳术后假体取出的患者,根据手术目的及乳房形态,选择合适的手术方案,方可取得令人满意的修复效果。

Objective To explore the surgical options in breast explant removal operation.Methods From January 2017 to June 2020,96 cases of silicone implant breast augmentation patients received implant removal operations in our department.Considering the purpose of operation,implant conditions,current breast shape and volume,all the patients were treated with four different surgical options:implant removal,implant replacement,mastopexy and implant removal,mastopexy and implant replacement,implant removal and fat graft.Results Hematoma were detected in 5 patients,partial wound disruption was detected in 1 patient,all of them were in mastopexy group.Follow-up lasted from 6 months to 3 years,the breasts were in good shape,there were no complications such as nipple-areola complex necrosis,hypertrophic scar formation or breast ptosis recurrence.All the patients were satisfied with the breast shape after secondary operations.Conclusions Based on the motivation of patients,the current breast and implant conditions,proper surgical planning could lead to satisfying results in implant removal operations.