不同类型乳房假体隆乳术后常见并发症发生率比较

Comparison of common complications after augmentation mammaplasty with different types of breast implants

目的 比较不同类型乳房假体隆乳术后常见并发症发生率。方法 从2020年1月至2021年2月期间,由同一组手术团队对450例患者(900侧乳房)实施经腋窝入路内窥镜下假体隆乳术,均使用曼托系列硅凝胶假体:光面圆形假体、毛面圆形假体、水滴形假体。随访时间为术后即刻至术后1年,获得有效随访病例400例,统计比较不同类型假体植入后常见并发症发生率。结果 所有患者均未发生气胸、假体感染、假体破裂渗漏、迟发性血清肿;1例患者(1侧)于住院期间发生假体腔隙内血肿,接受手术治疗,为毛面圆形假体;1例患者(1侧)于住院期间发生假体明显移位,接受手术治疗,为毛面圆形假体;5例患者(6侧)于术后1年随访期内发生假体移位,均为光面圆形假体;2例患者(2侧)发生mondor病,其中毛面圆形假体1例,光面圆形假体1例;3例患者(4侧)发生包膜挛缩,均为光面圆形假体,其中2例为Baker Ⅰ-Ⅱ级,1例为Baker Ⅲ-Ⅳ级;84侧乳房发生轻度乳头乳晕感觉障碍,其中光面圆形假体26例(30.95%),毛面圆形假体28例(33.33%),水滴形假体30例(35.71%)。结论 光面圆形假体相比于水滴形假体、毛面圆形假体,术后假体移位发生率、包膜挛缩率更高,其他并发症发生率无明显差异。

Objective To compare the incidence of common complications after augmentation mammaplasty with different types of breast implants. Methods From January 2020 to February 2021, 450 patients(900 breasts) underwent breast augmentation with implants via axillary approach by the same surgical team. All of them used Mentor series silicone gel implants: round smooth implants, round hairy implants, and drop shaped implants. The follow-up time was from immediately to one year after operation. 400 cases were effectively followed up, and the incidence of common complications after different types of implants implantation was statistically compared. Results No pneumothorax, implants infection, implants rupture and leakage, delayed seroma occurred in all patients;One patient(1 side) suffered from hematoma in the prosthetic cavity during hospitalization, and received surgical treatment;One patient(1 side) had obvious displacement of implants during hospitalization and received surgical treatment;Five patients(6 sides) had implants displacement during the follow-up period of 1 year after operation, all of them were round smooth implants;Two patients(2 sides) developed mondor disease, including one hairy round implants and one smooth round implants;Capsule contracture occurred in 3 patients(4 sides), all of them were smooth round implants, of which 2 were Baker Ⅰ-Ⅱ and 1 was Baker Ⅲ-Ⅳ;Mild nipple areola sensory disturbance occurred in 84 breasts, including smooth round implants in 26 cases(30.95%), hairy round implants in 28 cases(33.33%), and water drop implants in 30 cases(35.71%). Conclusion Compared with water drop shaped implants and hairy round implants, smooth round implants has a higher incidence of implants displacement and capsule contracture, and there is no significant difference in the incidence of other complications.