【摘要】 目的 探讨隆胸假体取出手术方法及术中技巧。 方法 2002年1月-2007年4月，对48例女性隆胸患者行假体取出术，其中聚丙烯酰胺水凝胶（HPAG）注射式隆胸41例；硅凝胶假体隆胸7例，其中包膜挛缩4例，硅凝胶假体破裂3例。年龄21~49岁，病程2~18年（平均6年）。回顾性分析上述患者假体取出手术方法及术中技巧。 结果 48例患者术后切口均Ⅰ期愈合。随访3个月，患者症状缓解明显，术后彩超显示假体取出彻底，注射式隆胸患者免疫指标明显好转。 结论 掌握好隆胸假体取出术的适应证，根据不同假体采用相应的手术方法及术中技巧，可以取得良好的手术效果。【Abstract】Objective To investigate the surgical methods and techniques of implants removal in breast augmentation cases. Methods From January 2002 to April 2007, 48 breast augmentation cases (aging from 21 to 49 years old) were treated with surgical implants removal.Course of disease lasted from 2 years to 18 years，with an average of six years.Polyacrylamide hydrogel injection augmentation was found in 41 cases, silicone gel implants in 7 cases (envelope crispation in 4 and implants rupture in 3). The surgical methods and techniques of implants removal were retrospectively analyzed. Results After three months’ fellow-up, all patients healed in stage 1 and presented obvious relief of symptoms.Implant was cleared compelely through color doppler test.Immune index recovered in polyacrylamide hydrogel injection augmentation cases. Conclusion If the indication and surgical methods and techniques of implants removal are mastered thoroughly, good results could be achieved.
ObjectiveTo evaluate the clinical value of multi-slice CT in the diagnosis of complications due to breast augmentation. MethodsWe collected the imaging data of 32 female patients who accepted multi-slice CT examination in the second People's Hospital of Chengdu after breast augmentation between February 2010 and February 2015. The position, shape, edge, internal density, leakage, rupture and hard nodules of the prosthesis were observed and analyzed carefully. ResultsIn the 32 patients with breast augmentation, 12 were normal with bilateral symmetry and without abnormal shape or density. Among the other 20 patients, 11 had capsular contracture, 5 had prosthesis leakage, rupture and hard nodules, 4 had breast infection, 1 had fibroadenoma, 1 had cystoma, and 5 had little calcified nodules in the breast tissue. ConclusionThe multi-slice CT scan can clearly and accurately show the position, shape and size of the breast prosthesis as well as the existence of leakage, rupture and hard nodules in the prosthesis. It plays a very important role in the diagnosis of the complications due to breast augmentation and can be effective guidance for clinical operation.
Objective To explore the surgical technique and preliminary safety and aesthetic results of endoscopic removal of injectable Amazingel with/without immediate prepectoral implant-based breast augmentation for patients. MethodsThe clinical data of 25 patients who underwent endoscopic removal of injectable Amazingel with/without immediate prepectoral implant-based breast augmentation between April 2020 and January 2024 and met the selection criteria was retrospective analysed. The patients’ age ranged from 33 to 73 years, with a mean of 50.4 years, and the body mass index ranged from 16.8 to 26.6 kg/m2, with a mean of 21.5 kg/m2. They were all bilaterally injected with Amazingel, and the time between initial injections and surgery ranged from 17 to 26 years, with a mean of 21.4 years. Early safety was evaluated by the incidence of early postoperative complications, and early aesthetic results were evaluated using Harris scores (including breast shape satisfaction, sensation satisfaction, and elasticity satisfaction) at 3 months after operation. Results There were 9 cases underwent Amazingel removal (group A) and 16 cases underwent Amazingel removal with immediate prepectoral implant-based breast augmentation (group B). Intraoperative removal of Amazingel ranged from 808 to 1 285 mL, with a mean of 1 050.7 mL; the mass of the capsule removed ranged from 36 to 169 g, with a mean of 103.6 g; and a gross anatomical prosthesis was used with a median size of 345 mL (range, 315-355 mL). The operation time ranged from 95 to 395 minutes, with a mean of 194.2 minutes; and the cost of the procedure ranged from 8000to 91 000 yuan, with a mean of 33 000 yuan. Patients had a median follow-up time of 22.7 months (range, 3.0-48.1 months). There was 1 case of intraoperative skin burn due to the operation of the electric scalpel, which healed naturally after operation without flap necrosis. There was no adverse conditions such as prosthesis outline showing, ripple sign, and capsular contracture during follow-up; a small amount of Amazingel residue was found in 2 patients at 1 year after operation. The Harris score at 3 months after operation was used to evaluate the early aesthetic results, and the breast shape, elasticity, and sensation satisfaction of group A were lower than group B, but the differences between the two groups were not significant (P>0.05). Conclusion Endoscopic removal of injectable Amazingel with/without immediate prepectoral implant-based breast augmentation is safe in the early stage with good aesthetic results, and it is also recommended that patients who had the indications for combined immediate breast augmentation after removal to rebuild the breast appearance.