包膜综合处理及假体置换联合大分子透明质酸注射治疗隆乳术后包膜挛缩

Comprehensive Capsular Treatment and Prosthesis Replacement Combined with Macromolecular Hyaluronic Acid Injection to Treat Capsular Contracture after Breast Augmentation

目的:探讨包膜综合处理及假体置换联合大分子透明质酸注射治疗隆乳术后包膜挛缩的效果。方法:选择2014年5月-2021年4月笔者医院收治的29例假体隆乳后包膜挛缩患者为研究对象,患者年龄21~53岁,初次假体隆乳后1~6年,平均2.3年,其中Baker分级Ⅲ级21例,Ⅳ级8例,单侧3例,双侧26例。采用乳晕切口,完全去除乳房增厚包膜11例,包膜松解18例,均置换假体。在隆乳术后即刻或术后48 h内,每侧注入大分子透明质酸10~20 ml,用于预防包膜再次挛缩。结果:29例患者术后即刻均获得满意外形,随访1~5年,乳房外形保持良好,柔软度好,无乳房疼痛、硬块和乳头感觉缺失,Baker分级Ⅰ级22例,Ⅱ级7例,无假体破裂、乳房下垂及上移等并发症。结论:包膜综合处理及假体置换联合大分子透明质酸注射治疗隆乳术后包膜挛缩疗效好,且能有效降低乳房包膜再次挛缩的概率。

Objective To investigate the effect of comprehensive capsular treatment and prosthesis replacement combined with macromolecular hyaluronic acid injection in the treatment of capsular contracture after breast augmentation.Methods From May 2014 to April 2021,29 patients with capsular contracture after breast augmentation in the author's hospital were selected as the research objects,aged 21-53 years,1-6 years after the first breast augmentation,with an average of 2.3 years.There were 21 cases of Baker gradeⅢ,8 cases of gradeⅣ,3 cases of unilateral and 26 cases of bilateral.Using areola incision,the thickened breast capsule was completely removed in 11 cases,and the capsule was released in 18 cases,and all of them were replaced with prostheses.Macromolecule hyaluronic acid 10-20 ml was injected into each side immediately or within 48 hours after breast augmentation to prevent capsular contracture again.Results All patients were followed up for 1 to 5 years,the breast shape and softness were good,and there was no breast pain,hard mass and loss of nipple sensation.There were 22 cases of Baker gradeⅠand 7 cases of Baker gradeⅡ.Conclusion Comprehensive capsular treatment and prosthesis replacement combined with macromolecular hyaluronic acid injection are effective in the treatment of capsular contracture after breast augmentation,and can effectively reduce the probability of capsular contracture again.