包膜外聚丙烯酰胺水凝胶注射隆乳材料取出同期双平面假体隆乳术

目的：探讨包膜外聚丙烯酰胺水凝胶注射隆乳材料取出同期双平面假体隆乳术的疗效。方法：在全麻＋局麻下,采用乳晕下缘弧形切口,在注射聚丙烯酰胺水凝胶隆乳的包膜外分离,然后完整取出聚丙烯酰胺水凝胶及其包膜。同时在胸大肌下分离,在乳房下皱襞处离断胸大肌起点,胸大肌下腔隙内放置引流管,并置入硅凝胶隆乳假体,调整乳房形态满意后逐层缝合乳腺组织、皮下组织及皮肤切口。结果：本组10例均一次性完整取出聚丙烯酰胺水凝胶及其包膜,假体隆乳术后形态满意。但由于包膜组织剥离范围较广,术后引流液较多,引流管放置时间较长,拔管时间为3～6天,平均4.5天。无一例发生伤口感染或愈合不良。结论：对于单腔包膜完整的注射聚丙烯酰胺水凝胶隆乳患者的再次手术,本方法简便易行,取出聚丙烯酰胺水凝胶完整,隆乳术后乳房形态满意,是一种较好的手术方式。

Dual plane augmentation mammoplasty by implanting silicon gel prosthesis following the removing of polyacrylamide hydrogel from the outside of the capsular

Objective To discuss curative effects of augmentation mammoplasty with implanting silicon gel prosthesis after removing of polyacrylamide hydrogel from the outside of the capsular.Methods Under the general anaesthesia and local anaesthesia,this method using arc incision at lower edge of the areola,and injected polyacrylamide hydrogel of breast augmentation was separated from the outside of the capsular,then the polyacrylamide hydrogel and its capsular were removed.At the same time,the pectoralis major muscle was separated.The starting point of the pectoralis major muscle in inframammary fold was cut off.Drainage tubes and silicone gel breast augmentation implant were placed in the pocket.After adjusting the breast to the satisfactory shape,the breast gland tissue,subcutaneous tissue and skin incision were sutured.Results All the polyacrylamide hydrogel and the capsular of the 10 patients were taken out at one time.All the implant breast augmentation operations were successful.However,because the range of the capsular tissue dissection was broader,therefore the fluid of drainage was more.Drainage tubes were put a longer time and as extubation time was 3～6 days.An average time was 4 and 5 days without any wound infection or impaired wound healing.Conclusions Regarding a complete single-chamber capsular of injected polyacrylamide hydrogel with breast augmentation,this method was simple.The polyacrylamide hydrogel was removed completely.Breast shapes were satisfactory after the operation.The method was a better surgery.