乳房假体植入术后乳房下皱襞低原因研究及处理.doc

乳房假体植入术后乳房下皱襞低原因研究及处理[摘要]目的:分析乳房假体植入手术后下皱襞低的原因及处理方法。方法:回顾性分析2006年5月～2007年4月期间192例各种乳房假体植入手术患者，共有5例因术后出现单侧乳房下皱襞低，其中1例为乳癌术后再造，2例为单纯隆乳术，2例为乳房聚丙烯酰胺水凝胶取出术后再次隆乳术患者，均施行乳房下皱襞重建手术修整。结果:所有患者术后恢复顺利，两侧乳房基本对称，随访3～6月，矫正效果稳定。结论:整形外科医师应当重视乳房整形手术中下皱襞的保护和重建。 [关键词]隆乳术；并发症；手术 [中图分类号]R622[文献标识码]A[文章编号]1008-6455（2008）05-02 Inferior mammary fold reconstruction in implant based augmentation mammoplasty ZENG Ang, QIAO Qun, ZHANG Hai-lin, BAI Ming, WANG Yang, ZHU Lin, FANG Bai-rong （Department of Plastic Surgery, Peking Union Medical College Hospital, Beijing 100032, China） Abstract： Objective To investigate the cause of inferior mammary fold (IMF) descending after implant based augmentation mammoplasty and to present a simple IMF reconstructive method. MethodsA retrospective analysis was performed. From May 2006 to April 2007, a total number of 192 cases received implant based augmentation mammoplasty in our center, and 5 cases were found unilateral low positioned IMF post-operatively. The causes of low positioned IMF were categorized into three: the over-dissection in breast augmentation, the failure of preservation of IMF during oncological operation, the residual gel-like material in the prosthesis pocket after breast polyacrylamide hydrogel removing operations. All patient received IMF recreation procedures through areola incision.ResultsThe IMF reconstructions were successful in these 5 patients. After follow up for 3 to 6 months, these patients presented with stable aesthetical satisfactory outcomes.ConclusionThe plastic surgeons should pay more attention to IMF preservation in implant based breast plastic surgery. In case of conservative methods fails, an areola approach IMF reconstruction could be easily applied. Key words: augmentation mammoplasty;complication;operation 乳房下皱襞是决定女性乳房美学形态的最重要因素之一。在各种乳房假体植入性手术中，如隆乳术、乳房再造术等，乳房下皱襞已成为手术过程中重要的引导性标志。下皱襞不对称必将影响乳房的美学效果。乳房下皱襞高通常是由于假体腔穴剥离不充分所致，多在门诊局麻即可简单处理。而下皱襞低则多需重建乳房下皱襞，处理相对复杂。我们对2006年5月～2007年4月期间发生乳房假体植入术后下皱襞低的病例作出回顾