腔镜技术联合彩色多普勒超声通过不同切口方式取出聚丙烯酰胺水凝胶注射隆乳剂

目的 探讨腔镜技术通过不同切口方式取出聚丙烯酰胺水凝胶(polyacrylamide hydrogel,PAHG)注射隆乳剂手术的临床效果,以取得最大隆乳剂清除率.方法 2008年1月-2011年3月双侧乳房PAHG注射隆乳术后并发症患者35例,将腔镜技术分别应用于经乳房外侧切口和经乳晕切口PAHG注射隆乳剂取出手术....

Application of Endoscopic Technique with Color Doppler Ultrasound in Removal of Injected Breast Augmentation Agent-Polyacrylamide Hydrogel through Different Incisions

Objective To explore the clinical outcome of endoscopic techniques in the removal of injected breast-augmentation polyacrylamide hydrogel（PAHG） through different incision methods in order to achieve a maximal PAHG removal rate.Methods From January 2008 to March 2011,35 patients with postoperative complications after bilateral breasts PAHG injection were diagnosed and treated in our hospital.Endoscopic techniques were applied to remove PAHG through the lateral incision of breast or the mammary areolar incision.Twenty-one patients were treated with lateral incision in which 1-3 incisions with a length of 0.5-1.0 cm were selected at hidden lateral sites of breasts,and PAHG was removed by vacuum sucking followed by endoscopic technique with Doppler color ultrasound to achieve a complete removal.Fourteen patients were treated with mammary areolar incision where an arc-shaped 2-3 cm incision was made under the lower margin of mammary areola.After vacuum sucking of PAHG,long head hook was used to lift the cyst and endoscopic technique was used along or alternate with sucking to remove the remaining PAHG.Doppler color ultrasound scanned to confirm the absence of PAHG mass.The clinical experiences of these two endoscopic techniques were compared and summarized.Results All patients successfully underwent the surgery and achieved a goal of maximal removal of PAHG.None of the patients had to switch surgery approach,and no such complications as post-surgery bleeding,infection,obstructed drainage or PAHG remaining occurred.Patients were all satisfied with the appearance of incisions.Six patients were given silicone prosthesis implantation after removing PANG through the areola incision,among whom one patient showed a decreasing sensitivity in mammary nipple and areola.Conclusions Both endoscopic techniques through the lateral incision of breast and the mammary areolar incision are safe,and can achieve maximal removal of PAHG.They both have the advantages of beautifying,minimal invasiveness and simultaneous removal of pathologic tissues.The mammary areolar incision facilitates implantation of silicone prosthesis simultaneously.The endoscopic techniques are worthy to be further applied into removal of PAHG.