Change in self-image pressure level before and after autologous fat breast augmentation and its effect on social adaptability

BACKGROUND There is an increasingly strong demand for appearance and physical beauty in social life,marriage,and other aspects with the development of society and the improvement of material living standards.An increasing number of people have improved their appearance and physical shape through aesthetic plastic surgery.The female breast plays a significant role in physical beauty,and droopy or atrophied breasts can frequently lead to psychological inferiority and lack of confidence in women.This,in turn,can affect their mental health and quality of life.AIM To analyze preoperative and postoperative self-image pressure-level changes of autologous fat breast augmentation patients and their impact on social adaptability.METHODS We selected 160 patients who underwent autologous fat breast augmentation at the First Affiliated Hospital of Xinxiang Medical University from January 2020 to December 2022 using random sampling method.The general information,selfimage pressure level,and social adaptability of the patients were investigated using a basic information survey,body image self-assessment scale,and social adaptability scale.The self-image pressure-level changes and their effects on the social adaptability of patients before and after autologous fat breast augmentation were analyzed.RESULTS We collected 142 valid questionnaires.The single-factor analysis results showed no statistically significant difference in the self-image pressure level and social adaptability score of patients with different ages,marital status,and monthly income.However,there were significant differences in social adaptability among patients with different education levels and employment statuses.The correlation analysis results revealed a significant correlation between the self-image pressure level and social adaptability score before and after surgery.Multiple factors analysis results showed that the degree of concern caused by appearance in selfimage pressure,the degree of possible behavioral intervention,the related distress caused by body image,and the influence of body image on social life influenced the social adaptability of autologous fat breast augmentation patients.CONCLUSION The self-image pressure on autologous fat breast augmentation patients is inversely proportional to their social adaptability.

Breast Fibromatosis after Hydrophilic Polyacrylamide Gel Injection for Breast Augmentation: a Case Report and Review of the Literature

BREAST fibromatosis is a rare kind of lesion. The average incidence is about 2-4 per million every year} So far there have been about 100 cases reported altogether.2 In this report, we describe a case of breast fibromatosis developed after hydrophilic polyacrylamide gel （HPG） injection for breast augmentation. By reviewing the literature, the possible pathogenesis of this case and the proper treatment strategy are investigated.

Observation on the Clinical Effect of Breast Augmentation by Transplanting Concentrated Growth Factor and Autologous Fat

Objective To explore the effect of concentrated growth factor(CGF)combined with autologous fat transplantation in augmentation mammoplasty.Methods Clinical data of 28 female patients who underwent autologous fat by CGF mixed with purified fat between May 2015 and June 2018 were retrospectively analyzed.Clinical evaluation was performed to observe and measure the shape of the breast after breast augmentation,the increase in the value of the nipple plane measurement,and complications.Results All of 28 patients,after 12 months of follow-up,all patients no fat infection,hematoma,breast nodules and other complications.It showed that the contouring of breast were improved and more chubbiness than that before operation.The results were satisfied from patients.Conclusion Concentrated growth factor combined with autologous fat transplantation has a stable breast augmentation effect,beautiful breast shape,simple operation and small damage,which achieves breast rejuvenation.

Polyacrylamide gel migration after injection for breast augmentation:A case report

Polyacrylamide hydrogel(PAAG)was once considered a safe,reliable,and compatible injected filler and was widely used in breast augmentation,rhinoplasty,and other cosmetic surgeries.However,numerous complications,such as implant migration,have been observed after PAAG injections.Herein,we report a rare case of distant implant migration after PAAG injection for breast augmentation in which the material became displaced along the abdominal wall to the perineum and pelvic extraperitoneal space.After a well-prepared preoperative evaluation involving magnetic resonance imaging(MRI)and computed tomography(CT)examinations and threedimensional hologram,debridement surgery was performed to remove the injected material.After the operation,the patient was followed up for two years and was not scheduled for a second operation.Postoperative complications of breast augmentation after PAAG injection,especially gel migration,still affect thousands of patients.Once material migration occurs,surgical removal becomes difficult.Early diagnosis and treatment are recommended.

Repeated lumps and infections: A case report on breast augmentation complications

BACKGROUND Polyacrylamide hydrogel(PAAG)injections were once common in breast augmentation and have been prohibited for augmentation mammaplasty in China since a large number of patients who underwent breast augmentation with PAAG injections have continued to seek medical advice as a result of related complications.Among all these complications,distant migration is relatively rare.CASE SUMMARY A 49-year-old female presented at the hospital with a one-year history of a vulvar lump.The sonography of the lump showed several subcutaneous fluid-filled regions from the left vulva to the pubic symphysis,which suggested possible fat liquefaction.An enhanced magnetic resonance imaging(MRI)revealed a cystic area,which was considered a benign lesion.Intraoperative observations showed that the mass did not have an obvious capsule,the subcutaneous tissue presented as a cavity,and some yellow material came out of this cavity.A culture of the drainage did not show bacterial contamination.Histopathology revealed a foreign body granuloma.After resection and closed drainage,lumps were successively observed in the left lower abdomen and the bilateral hypochondriac region with infections.Sonography found that the hypoechoic areas in the bilateral hypochondriac region seemed continuous with deep in the breasts.The patient reported that she had undergone surgery with PAAG injections 20 years ago after she was repeatedly asked about her past history.Finally,a diagnosis of distant migration of PAAG was made.CONCLUSION PAAG gel can migrate after long periods of time.A diagnosis should not be limited to the area where the symptom develops.

Perinipple Broken Line Incision: a Novel Approach for Breast Augmentation

Objective To investigate reliability of the infra-nipple broken line incision for breast augmentation. Methods From January 2012 to January 2013, 15 patients underwent primary bilateral retromuscular breast augmentation with round textured silicone-gel implants and a novel infra-nipple broken line incision. Preoperatively, a semicircular incision was marked along the inferior base of the nipple. It was then extended bilaterally using two transverse right-angled geometric broken lines within the pigmented areolar skin. Follow-up was performed to evaluate the sensation of nipple-areolar complex, the scar, and the shape and texture of the breasts. Results The average follow-up was 6.7 months. Most of the patients complained of paresthesia of the nipple or breast skin, but transient decreased sensation improved within 3 months. No patients showed permanent sensory changes of the nipple areolar complex at a minimum follow-up of 4 months. The scars were imperceptible in all patients. Conclusion We believe that for selected patients, the infra-nipple broken line incision is a practical and reliable method to achieve aesthetic result.

Bi-plane breast augmentation:a case series supporting its use and benefits

Aim:Breast augmentation has traditionally been performed in either the subglandular or submuscular plane.Dual plane augmentation has been described before and captures the advantages of both of these techniques but reduces the trade-offs.The biplane muscle splitting technique adopts the similar advantages seen with the dual plane method without the need for extensive costal muscle fibre release at the infra-mammary fold.Methods:Thirty-five patients underwent bilateral breast augmentation using the biplanar technique from November 2007 to December 2008.All operations were performed by the senior author and followed up prospectively.Results:Follow up ranged from 9 months to 21 months.All of the patients achieved precise and reliable implant placement with no revisions or patient dissatisfaction.There have been no cases of implant misplacement/migration;synmastia,dynamic breast deformity,capsular contracture or infections.A single case of unilateral haematoma occurred early in the series.Conclusion:Our operative cases and early follow-up supports the use of this novel biplanar technique for breast augmentation.It optimizes the advantages of subglandular and submuscular breast augmentation with simpler dissection and less complications than other submuscular techniques.It can be used in a wide variety of breast types with predictable results.

MODIFIED DISSECTION OF SUBPECTORAL SPACE FOR BETTER AESTHETICAL AUGMENTED BREAST

Objective To reconstruct an augmented breast that resembles a virginal one that is difficult to be achieved by the traditional technique. Methods We modified the dissection of the subpectoral space by extending it over the sternum edge 1cm medially and beyond the breast crease 2cm inferiorly, yet keeping strictly the upper border of the space on the third rib and the lateral border on the anterior axillary line. Results All 50 patients were satisfied with their augmented breasts which nearly resembled the virginal ones. Conclusion Our modified dissection enabled the mammary implant to stay in the position where it originally was and not be pushed upward and laterally by the pectoral muscle contraction as usually seen by the traditional technique.

乳房整形美容术后早期疼痛的临床特征研究

目的调查三类乳房整形美容手术后早期患者疼痛的临床特征,为优化疼痛管理方案提供依据。方法收集2021年11月至2022年8月收治的72例行隆乳术、乳房缩小成形术、乳房悬吊术的患者资料,于术后1 d、2 d、3 d分别记录疼痛水平(数字疼痛评分、修订版面部表情疼痛评估法)、疼痛部位、伴随症状、用药情况,分析疼痛的临床特征。结果术后1~3 d的疼痛水平总体呈现下降趋势。隆乳术后的患者疼痛水平最高,持续处于中等疼痛水平,疼痛部位以腋下(68.60%)、乳房上方(49%)居多;乳房缩小成形术、乳房悬吊术后患者的疼痛部位以乳房下缘(33.30%)、乳晕(33.30%)和乳房外侧(26.70%)为主,部分位置的双侧乳房疼痛发生率不一致。多数患者不伴有其他症状。58.33%的患者在术后1 d使用1种药物镇痛,37.5%的患者在术后2 d使用2种及以上药物镇痛,76.39%的患者在术后3 d无需使用药物。结论隆乳术后患者的早期疼痛值得重点关注,疼痛发生位置主要与切口、引流留置、假体植入、血肿发生有关。在评估疼痛时应关注双侧乳房疼痛的区域特征,识别疼痛原因,尽早发现并预防血肿。镇痛药物的选择应避免同机制药物的叠加使用,实施多模式镇痛,联合非药物干预措施,共同管理疼痛及药物不良反应。

自体脂肪移植隆胸术后脂肪坏死1例并文献复习

随着生活水平的提高,乳房的美观性越来越受到女性的重视。隆胸手术是改变小乳房的主要方式,包括植入假体、自体组织隆胸及脂肪植入等。自体脂肪作为一种理想的替代填充物,在重建手术中具有较多优势,如来源丰富、易获取、质地柔软、灵活性强及免疫原性低等。自体脂肪移植技术日益受到欢迎,但可能带来一系列不良后果,如脂肪坏死、存活率低及脂肪栓塞等。脂肪坏死与乳腺癌在影像学上相似,术后需病理排除恶性肿瘤。本文报道1例在美容院接受自体脂肪移植隆胸术后脂肪坏死的案例,通过复习相关文献,全面总结脂肪坏死的诊断与治疗策略,以期提高临床对自体脂肪移植隆胸术后脂肪坏死的认知,为临床实践提供参考和依据。

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

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。

两种不同入路行双平面假体隆乳术临床疗效对比研究

目的探讨不同入路行双平面假体隆乳术的效果。方法回顾性分析2020年1月—2023年1月新乡市中心医院收治的629例行双平面假体隆乳术患者的临床资料,按其手术入路的不同将其分为2组,其中经乳晕入路行手术的329例患者纳入对照组,经腋窝入路行手术的300例患者纳入观察组,术后均随访6个月。对比2组手术相关指标、乳房形态变化、隆胸效果、并发症。结果观察组切口愈合时间[(7.30±1.25)d]短于对照组[(9.21±1.69)d],并发症发生率(1.67%)低于对照组(4.86%),差异有统计学意义(P<0.05)。2组术中出血量、手术时间、住院时间、术后数字评分法(numeric rating scale,NRS)评分、隆胸效果相比,差异无统计学意义(P>0.05)。术前、术后2组乳头-乳房下皱襞的经皮距离(nipple to inframammaryfold,N-IMF)、胸骨切迹-乳头距离(sternal notch to nipple,S-N)、乳头-正中线距离(nipple to midline,N-M)、乳房总体积相比,差异无统计学意义(P>0.05)。结论经乳晕入路、经腋窝入路行双平面假体隆乳术均能够取得优良的隆胸效果,但经腋窝入路行手术更能够促进切口愈合,降低并发症发生率。文章的研究结果为临床后期选择双平面假体隆乳术的入路提供了借鉴内容,具有一定的运用价值。

经下皱襞切口假体隆乳术矫正小乳症及乳腺萎缩

目的:探究经下皱襞切口假体隆乳术矫正小乳症或乳腺萎缩的临床疗效及并发症发生率。方法:选取2021年01月-2022年12月笔者医院收治的97例行经下皱襞切口假体隆乳术的小乳症或乳腺萎缩就医者临床资料进行回顾性分析。所有就医者术中使用超声刀精准剥离双平面腔隙后使用一次性隆乳手术用漏斗置入假体,并予以精细化超减张缝合切口。术后,总结分析临床疗效和并发症。结果:本组97例就医者共置入194只硅凝胶假体,单侧假体平均体积(252.73±3.53)ml,手术时间(99.41±9.35)min,术后引流量(44.00±6.84)ml,术后疼痛VAS评分第1天(3.08±0.83)分、第2天(1.95±0.76)分、出院时(1.62±0.69)分,住院时间(2.51±0.75)d。术后随访6~24个月,所有就医者均表示术后乳房形态饱满、柔软度较佳、切口瘢痕隐藏化。JY-Breast-Q量表评价结果显示,手术增加了就医者自信,提高了就医者的生活质量。结论:经乳房下皱襞切口矫正小乳症或乳腺萎缩具有手术路径短,操作简单、术野直视、创伤小、术后康复快及并发症发生率低的优势。

假体隆乳术后发生包膜挛缩的多因素分析

目的研究假体隆乳术后包膜挛缩发生的相关因素。方法采用回顾性对照研究的方法,对2019年4月到2020年1月收治的227例硅凝胶假体隆乳手术患者的临床资料进行分析,依据是否发生包膜挛缩分为包膜挛缩组和对照组。随访24个月,比较两组患者的年龄、BMI、吸烟史、哺乳史、手术入路、假体品牌及表面性状、假体是否选择过大、是否使用内窥镜、引流量及有无血肿,并对有显著相关性的因素进行回归分析。结果两组的年龄、BMI、哺乳史、手术入路、假体品牌、假体表面性状、是否使用内窥镜及引流量等差异均无统计学意义(P>0.05),吸烟史、假体选择过大及血肿等因素与包膜挛缩的发生显著相关(P<0.05)。Logistic回归分析结果显示,在纠正了手术入路、假体表面性状及是否使用内窥镜后,吸烟史(OR=2.968,95%CI:1.385~6.365)、假体选择过大(OR=6.028,95%CI:2.448~14.845)及血肿(OR=14.560,95%CI:1.783~118.922)等因素仍与包膜挛缩呈正相关。结论吸烟史、假体选择过大及血肿增加了包膜挛缩的发生率,具体机制仍需进一步研究。

内窥镜在下皱襞切口双平面光面假体隆乳中的应用

目的探讨内窥镜在下皱襞切口双平面光面假体隆乳中应用的可行性、安全性及有效性。方法下皱襞切口隆乳术中,在剥离胸大肌后间隙时置入内窥镜,可视化下进行腔隙的精准剥离、确切止血,可减少组织损伤。对手术时间、住院时间、引流情况、舒适度、并发症、术后效果、满意率等进行分析。结果本组共108例患者,均采用全身麻醉,均使用光面假体,均采用双平面技术。38例选择曼托假体,48例选择娜绮丽假体,14例选择星熠假体,8例选择伊思雅假体。假体大小220~350 cc。1型双平面98例(90.7%),2型双平面8例(7.4%),3型双平面2例(1.9%)。平均手术时间72 min,平均住院2 d。放置引流患者30例(27.8%),未放置引流患者78例(72.2%)。2个乳房(0.9%)出现血肿,1个乳房(0.5%)出现Ⅲ级包膜挛缩,2个乳房(0.9%)出现假体移位,3个乳房(1.4%)术后瘢痕明显。术后镇痛者18例(16.7%),未镇痛者90例(83.3%)。术前乳头到下皱襞距离为(5.80±0.43)cm,术后为(8.05±0.33)cm,差异显著(P<0.05)。达到患者预期并对大小、形态、手感等非常满意的有88例(81.5%),满意15例(13.9%),满意率95.4%。结论在下皱襞切口中应用内窥镜进行双平面光面假体隆乳效果良好,满意率较高,并发症较少,是可行并安全、有效的。

内窥镜下超声刀与电刀辅助假体隆乳术的临床疗效对比

目的:分析对比内窥镜下超声刀与电刀辅助假体隆乳术的临床疗效。方法:选择2021年8月-2023年2月预在笔者医院进行内窥镜辅助假体隆乳术的女性就医者300例,依据随机数字表法分为对照组和研究组各150例。对照组采用电刀分离腔隙,研究组采用超声刀分离腔隙。手术相关指标、临床疗效、炎症因子水平及就医者满意度。结果:研究组全程手术用时及住院时间均短于对照组(P<0.05),术中出血量、术后第1、2天24 h单侧引流量均少于对照组(P<0.05),术后第1天VAS评分低于对照组(P<0.05)。术后1 d,两组C反应蛋白、白细胞介素-6均高于术前(P<0.05),但研究组低于对照组(P<0.05)。术后4周,研究组临床疗效优良率为97.33%,高于对照组的85.33%(P<0.05),研究组就医者满意度为97.33%,高于对照组的92.00%(P<0.05)。结论:与电刀分离相较,采用超声刀分离更利于提升内窥镜辅助假体隆乳术的临床疗效,缩短全程手术用时、住院时间,减少术中出血量、引流量,降低疼痛程度、炎症反应,且就医者满意度高。

超高位双平面(三平面)假体隆乳术的疗效观察和优势分析

目的:分析超高位双平面假体隆乳术的临床结果,探讨更适合亚洲人的假体隆乳术方式。方法:选取2019年8月-2022年8月笔者医院接受假体隆乳术的289例就医者进行回顾性分析,年龄18~56岁,平均35.7岁,采用改良后的双平面技术,在乳头乳晕水平全层横向离断胸大肌,断端分别向上向下回缩,形成上下两个袋状肌瓣,上瓣覆盖了假体上极,下瓣将假体装入袋中,肌肉断端回缩后的乳头乳晕位置假体覆盖为乳腺筋膜后。结果:术后随访13~36个月,平均随访19个月。超高位切断胸大肌后,向上回缩的肌瓣覆盖假体上极,减少假体边缘感和皮肤皱褶;向下回缩的袋状肌瓣将假体装入袋中,既改善乳房下极的丰盈度,减轻假体的触及感,又提高假体的稳定性。另外,超高位切断的胸大肌,保留运动神经支配上部肌瓣收缩时,肌肉呈水平矢量收缩,使假体向下运动最小化;而失去神经支配的下部肌瓣抵消胸肌收缩对假体产生向下的压力,有效地减少动态畸形和双泡畸形。所有患者乳房外形美感佳,手感柔软逼真,假体边界不明显,乳房活动度正常,就医者满意度高。结论:超高位双平面假体隆乳术是一项可靠的技术,可以给假体提供良好的组织覆盖和自然、持久的效果,减少了传统双平面的不足和缺陷,是更适合亚洲人的假体隆乳手术。

假体置入联合自体脂肪移植隆乳术在临床中的运用探讨

目的 探讨假体置入和自体脂肪移植隆乳术联合应用的效果。方法 选取2021年2月—2023年4月山东省东营市东营区中医院整形外科接受隆乳手术的65例患者作为研究对象。按照随机数表法分为两组,对照组(n=30)行假体置入隆乳术,研究组(n=35)行假体置入+自体脂肪移植隆乳术。比较两组手术指标、手术效果、并发症发生情况及患者满意度。结果 研究组术中出血量、引流量少于对照组,引流管留置时间、住院时间短于对照组,治疗效果满意度评分高于对照组,差异有统计学意义(P均<0.05)。研究组手术优良率为91.43%,高于对照组的66.67%,差异有统计学意义(χ^(2)=6.191,P<0.05)。研究组的并发症发生率为5.72%,低于对照组的23.33%,差异有统计学意义(χ^(2)=4.204,P<0.05)。结论 采用假体置入和自体脂肪移植联合手术可提高隆乳优良率,降低并发症发生风险,提升患者满意度。

氟比洛芬酯复合舒芬太尼、托烷司琼用于假体隆乳术后镇痛的临床效果

目的分析氟比洛芬酯复合舒芬太尼、托烷司琼在假体隆乳术后的镇痛效果。方法回顾性分析我院2023年6月-2023年9月收治的32例术后采用氟比洛芬酯复合舒芬太尼、托烷司琼经静脉患者自控镇痛(patient controlled intravenous analgesia,PCIA)的假体隆乳术患者的麻醉资料(观察组),同时回顾性收集2023年1月-2023年5月收治的32例术后采用舒芬太尼、托烷司琼PCIA的假体隆乳术患者的麻醉资料(对照组)。比较两组患者舒芬太尼用量、按压次数,术后不同时间点疼痛程度、血流动力学状况以及两组术后引流量和不良反应发生情况。结果两组手术时间无统计学意义(P>0.05),观察组舒芬太尼用量、按压次数少于对照组少,差异有统计学意义(P<0.05);观察组术后4h、术后8h、术后12h、术后24h、术后48h的VAS评分均低于对照组,组间差异有统计学意义(P<0.05);观察组术后4h、术后12h的SBP、DBP、HR低于对照组组间差异有统计学意义(P<0.05),两组SpO2比较差异无统计学意义(P>0.05);两组术后24h引流量、不良反应发生率比较,差异无统计学意义(P>0.05)。结论氟比洛芬酯复合舒芬太尼、托烷司琼在假体隆乳术后镇痛中效果确切,在有效镇痛的同时可减少阿片类药物用量,并稳定血流动力学,且具有较好的安全性。

Clinical Observation of Breast Conserving Surgery and Modified Radical Mastectomy in the Treatment of Early Breast Cancer

The purpose of the study was to compare the clinical efficacy of breast conserving surgery and modified radical mastectomy in the treatment of early breast cancer.Firstly,the clinical data of 74 patients with early breast cancer treated in our hospital from June 2015 to June 2016 were retrospectively analyzed.Among them,37 patients treated with breast-conserving surgery were set as the study group,and 37 patients treated with modified radical surgery were set as the control group,and the therapeutic effects of the two groups were compared.The results showed that compared with the control group,the incision length,intraoperative blood loss,operation time and hospital stay time were better in the study group,and the excellent and good rate of postoperative breast beauty was higher,with statistically significant differences(P<0.05).There were no statistically significant differences in distant metastasis rate,local recurrence rate,axillary lymph node recurrence rate and fatality rate between the two groups(P>0.05).Therefore,breast-conserving surgery and modified radical surgery have better efficacy in the treatment of early breast cancer,but breast-conserving surgery has more advantages,such as smaller incision,less intraoperative blood loss,shorter operative time and hospital stay,and better postoperative aesthetic effect,which can be used as the first choice for early breast cancer.