经腋窝切口内镜辅助双平面隆乳技术的临床应用

目的 介绍经腋窝切口内镜辅助下双平面隆乳术的技术要点及临床效果.方法 通过对89例手术病例分析,从术前设计、术中操作技巧、术后处理三方面归纳总结出其技术要点.结果 89例受术者均未出现术中难以控制的出血,术后均无明显乳头、乳晕感觉丧失.71例获得6～12个月随访.1例出现右侧包膜挛缩BakerⅢ级,其余均为BakerⅡ级以下,并对术后形态均感满意.结论 采用内侧腔隙钝性分离可减少术中出现难以控制的大出血,外侧第4～5肋间范围钝性分离可大大减少第4～5肋间神经的损伤.腔隙内下方、外下方用内镜引导行锐性分离可有效达到双平面Ⅰ型.术后常规放置引流管并适当加压包扎,可减少术后创面渗血及积液的产生.

Clinical applications of dual plane breast augmentation under endoscope through transaxillary incision

Objective To introduce the technical key points and clinical efficacy of dual plane breast augmentation under endoscope through a transaxillary incision.Methods By analyzing the 89 surgical cases,we have summarized the key points of the pre-operative design,surgical skills and postoperative management.Results All patients had no uncontrolled bleeding during operation and loss of nipple and areola sensation.71 patients got 6-12 months follow-up,showing that only one case presented with unilateral capsular contraction,and the others had satisfied results.Conclusions Blunt dissection can reduce the risks of uncontrolled bleeding on the inner side of the pocket and the damage of the nerves on the lateral side of the dissecting pocket.The lower inner part,lower part and lower lateral part are the areas that could be sharply dissected by electrocautery under endoscope to achieve the dual plane Ⅰ.The drainage and bandage are necessary after the operation.