经乳头根部小切口盐水假体隆乳术-30例临床回顾

目的：选择合适的皮肤切口入路,操作方便,组织损伤小,术后瘢痕不明显是未来隆乳术的发展方向。基于这一原则,笔者选择经乳头根部小切口行盐水假体隆乳术,旨在观察术后的效果。方法：全麻或局麻下,于乳头下侧缘距基底部2mm处设计半环形切口。对于乳头过小者,可向两侧乳晕水平方向延长5mm,总长度小于2．5cm。沿此切口切开皮肤全层,沿乳腺导管走行方向分离,在乳腺下或胸大肌下制造腔穴,将充注式盐水袋假体置入腔穴。再将200ml～300ml盐水通过阀门注入。观察双侧乳房大小、形状、对称性均满意后分层缝合和包扎。结果：从2000年1月～2007年12月,我们用此种方法行隆乳术30例。术后早期5例患者出现乳头感觉暂时减退,1～3月后均恢复正常。10例乳房表面出现局部轻微褶皱塌瘪,2例假体破裂,取出后再次置入新假体。无乳头畸形、包膜挛缩、双侧不对称,所有患者对切口瘢痕感到满意。结论：经乳头根部小切口置入盐水充注式假体手术,操作简便,安全性高,损伤乳腺组织少,愈后切口瘢痕隐蔽。该术式是可行的,值得在临床上推广应用。

Augmentation mammaplasty using perithelial incision for a saline breast implant: a retrospective analysis of 30 cases

Objective Convenient and less invasive operating procedure with minimal postoperative scar are the developing directions. Purpose of this paper is to describe a small perithelial incision in order to produce an inconspicuous postoperative scar with excellent patient satisfaction. Methods Thirty patients underwent surgery under either general or local anesthesia by a single surgeon between January 2000 and December 2007. We applied perithelial incision, which was 2mm higher than lower nipple margin. We could extend 0.5cm up to bilateral horizontal areola with the small nipple. Total incision length was less than 2.5cm.The pocket plane was dissected through subpectoral or subglandular for implant placement. The saline breast implants with diaphragm valve were inserted, and 200-300ml saline was injected which was followed by sealing in layers and wrapping up the incisions after confirming the symmetrical size and shape for both breasts. Results All the patients displayed excellent satisfaction postoperatively and at final follow-up, which had minimal scar formation and good quality of healing. There were no deformation and capsular contracture of nipples, and no implant asymmetry bilaterally. Mild post-operative sensory loss was present in 1 up to 3 months postoperatively in 5 patients, which was resolved ultimately. Ten patients had rippling and two patients required insertion of new implants because of rupture of implants. Conclusions This Small perithelial incision is an effective and high safety alternative technique for augmentation mammaplasty with saline-filled implants, which has less complication rate with minimal scar formation. Wide spread application of this implant is recommended.