CAJ | 학술논문

目的探索在内镜辅助剥离下隆乳术中先置入扩张器进行即时超量注水扩张,完成后再置换假体的隆乳术方法及临床效果.方法按照术前设计,腋下入路在内镜辅助下完成双平面剥离后,置入乳房假体前预先置入组织扩张器,注入生理盐水至术前预定假体的容量,观察注水后扩张器大小和位置并调整至合适程度,调整后注水量作为选择假体体积的参考.在此基础上继续即时超量注水至2倍体积,保持扩张30～60 min后,取出扩张器,置入乳房假体,完成手术.结果 120例,术后除3例早期出现血清肿后自然吸收,2例位置不佳进行Ⅱ期调整,1例出现包膜挛缩经修复后好转外,其余通过半年至2年随访,均表现为手感、动感自然,外形和谐对称,满意率达95％.结论隆乳手术中预先置入扩张器以便进行位置调整,可以避免置入假体后再做调整对假体有损伤,可以通过增减注水量使两侧乳房大小对称,预估最后采用假体的体积,尤适用于两侧乳房不对称患者.有减轻隆乳患者术后乳房胀痛、改善乳房外形和手感的效果.
목적 탐색재내경보조박리하륭유술중선치입확장기진행즉시초량주수확장,완성후재치환가체적륭유술방법급림상효과.방법 안조술전설계,액하입로재내경보조하완성쌍평면박리후,치입유방가체전예선치입조직확장기,주입생리염수지술전예정가체적용량,관찰주수후확장기대소화위치병조정지합괄정도,조정후주수량작위선택가체체적적삼고.재차기출상계속즉시초량주수지2배체적,보지확장30～60 min후,취출확장기,치입유방가체,완성수술.결과 120례,술후제3례조기출현혈청종후자연흡수,2례위치불가진행Ⅱ기조정,1례출현포막련축경수복후호전외,기여통과반년지2년수방,균표현위수감、동감자연,외형화해대칭,만의솔체95％.결론 륭유수술중예선치입확장기이편진행위치조정,가이피면치입가체후재주조정대가체유손상,가이통과증감주수량사량측유방대소대칭,예고최후채용가체적체적,우괄용우량측유방불대칭환자.유감경륭유환자술후유방창통、개선유방외형화수감적효과.
Objective To evaluate the results of prosthesis augmentation,relieve suffering patient experience,improve shape and touch of breast.Methods According to design,in dual-plane mammaplasty transaxillary approach with endoscopic assistance,we used soft-tissue expansion before prosthesis,saline volume in expander was the same as prosthesis size at beginning; adjusting expander volume and position,then determined prosthesis size according to expander volume lastly.after intraoperative sustained expansion for 30 to 60 minutes twice prosthes volume,replace expander with prosthesis.Results This method was applied in 120 patients,showing that pain significantly reduced after expansive without use of analgesia pump; complications included that 3 patients appeared seroma and absorbed soon; 2 patients had poor prosthese location,which was adjusted in reoperation; one capsular contracture was repaired later.After 6-months to 2-years follow-up,the results showed that breast was nature and dynamic; satisfactory rate reached to 95 ％.Conclusions In augmentation mammaplastic operation,pre-adoption of an expander can make it easy to adjust the location of prosthesis,to avoid being injured and to determine prosthesis volume by expander injection of saline volume,especially for patient with different size of both breasts.