医用聚丙烯酰胺水凝胶注射隆乳后硅凝胶假体置入时机的选择

背景：医用聚丙烯酰胺水凝胶注射隆乳的并发症较多,取出后再次置入硅凝胶假体的时机尚不明确。 目的：探讨医用聚丙烯酰胺水凝胶注射隆乳后取出,再次行硅凝胶假体置入隆乳的最佳时机。 方法：纳入聚丙烯酰胺水凝胶注射隆乳后出现不良反应的18例患者,共33只乳房,聚丙烯酰胺水凝胶取出6个月后行硅凝胶假体置入隆乳。置入后随访,调查内容包括局部体征、乳房的轮廓形态、大小、位置、手感、影像学检查结果和心理状况等,将反馈信息分为优、良、中、差4个等级。 结果与结论：随访6个月~2年,聚丙烯酰胺水凝胶取出6个月后行硅凝胶假体置入隆乳优良率超过90%,乳房外形丰满圆润,呈水滴形,轮廓自然柔美,手感柔软有弹性,无压痛,无硬结及游走性包块。提示医用聚丙烯酰胺水凝胶注射隆乳后出现不良反应或患者要求取出者,取出6个月后再行硅凝胶假体置入隆乳可最大限度地避免聚丙烯酰胺水凝胶以及取出手术创伤对隆乳后效果的影响。 关键词：聚丙烯酰胺水凝胶;注射隆乳;硅凝胶假体置入;手术时机;并发症 doi:10.3969/j.issn.1673-8225.2012.12.022

Optimal time window for implanting silicone prosthesis after augmentation mammoplasty with polyacrylamide hydrogel

BACKGROUND: There are many complications after augmentation mammoplasty with polyacrylamide hydrogel, but the optimal time window for implanting silicone prosthesis after removing polyacrylamide hydrogel is still unclear. OBJECTIVE: To investigate the optimal time window for implanting silicone prosthesis after removing polyacrylamide hydrogel in augmentation mammoplasty. METHODS: Eighteen patients (33 mammas) with complications after augmentation mammoplasty with polyacrylamide hydrogel were subjected to implantation of silicone prosthesis at 6 months after removing polyarylamide hydrogel. A follow-up visit was performed including local sign, breast contour shape, size, location, feel, imaging findings and psychological status, and all the feedback information was graded as excellent, good, moderate, and poor.  RESULTS AND CONCLUSION: The follow-up results of 6 months to 2 years showed that the excellent and good rate was over 90%. The breast was round and full bodied, presenting with a drop-like shape, the contour is naturally soft, and it was soft and flexible to the feel, as well as no tenderness and wandering mass were found. It is indicated that the implantation of silicone prosthesis at 6 months after removing polyacrylamide hydrogel can avoid the impact of polyacrylamide hydrogel on augmentation mammaplasty at the most.