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Objective To analyze the long-term follow-up result of mammaplasty by autologous granular adipose transplantation.Methods In combination with literature review,the late result was studied by means of a 18 years follow-up in a case of mammaplasty with autologous granular adipose transplantation.Results In this case,2 cm thickness of adipose tissue was formed in submammary space,it lacked lobule structure,adipose cells appearred in different size in some region,and nerve fiber was not observed.Under the same observing condition,capillary quantity in this adipose tissue was more than that in normal subcutanous fat,and the difference was significant (P ＜0.05).Conclusions If appropriate operation is carried out,the autologous granular adipose transplantation would be a safe and effective mammaplasty.The tranplanted fat might form new adipose tissue,which could survive for a long time.
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Objective To observe the clinical effect of water-assisted liposuction system using in the breast augmentation surgery.Methods From 2015 to 2017,we received 30 new patients who were diagnosed as small breast disease.The water-assisted liposuction system (Body-jetTM) was used to harvest autologous fat,and then autologous fat grafting was preformed in the breast augmentation surgery.The follow-up was conducted one year after operation to observe the change of breast size,fat survival rate,and the occurrence of postoperative complications.Results There was no any serious complication happened in all the 30 cases.The breasts got a good shape and soft feeling after long-term follow up.Conclusions The application of body-jetTM water-assisted liposuction system is safe;the survival rate of autologous fat transplantation is high,and the clinical effect is satisfactory.
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Polyacrylamide hydrogel (PAAG) was developed in the 1980s as an injectable filler for breast augmentation and tissue contour improvement, but its potential risk for oncogenesis and the frequent occurrence of chronic complications after injections led to the prohibition of its further use as an injectable material. Although breast augmentation with PAAG injections was mostly performed in China and Eastern Europe, the migration of patients and long-term complications of the procedure made it a global concern. Herein, we describe the case of a 49-year-old woman who immigrated to Korea after undergoing breast augmentation via PAAG injection in China, and complained of persistent mastodynia and retraction of both breasts. Surgical treatment was undertaken, along with removal of the PAAG and total capsulectomy of the fibrous capsule containing the gel through an inframammary fold incision. We share our experience of diagnosing and treating this case, and present a literature review.
Subject(s)
Female , Humans , Middle Aged , Breast , Carcinogenesis , China , Europe, Eastern , Hydrogels , Korea , Mastodynia , Pregnancy-Associated alpha 2-MacroglobulinsABSTRACT
Objective To investigate the efficacy of breast tissue flap cohesive treatment after breast augmentation injection mixture dis-placed.Methods A total of 78 patients with breast augmentation injection mixture polyacrylamide hydrogel(PAAG)shift in our hospital from January 2006 to March 2014 were divided into two groups according to different surgical methods,39 cases with the material shifted to abdominal wall in control group were treated by taking the cleaning operation to scrape residual cavity,39 patients in observation recieved new breast tissue flap design local treatment of breast fistula closed chest and abdominal wall channel after surgical elimination of the same abdom-inal wall cavities.Results The PAAG extensive deposition in the breast tissue,armpits,chest wall clearance were formed fistula communica-tion.The secretions of patients treated with tissue flap decreased 82%,the lacunar lesions reduced 80% after 2 weeks,while patients without tissue flap,the drain reduced 46%,the lesion size reduced 45%,the difference between the two groups was significant(P <0.01).The heal-ing rate of tissue flap group was higher than that of conventional group after 4 weeks.Conclusion The PAAG mixture shifting formed fistula communication in the abdominal wall is the main reason of the mass flow and a huge cavity.Flap can significantly promote abdominal wall fis-tula healing.
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Although IMF incision is known the best way for anatomic implant, most Korean doctors and patients hesitate IMF incision. Anatomic form stable implants have some benefits such as less prominent upper pole, less wrinkles and ripples, and less rupture rate than round cohesive type I implants. However more concern is necessory for placing the anatomic implants. The Korean Academic Association of Breast Surgery(KAABS) planned to support some tips for using anatomic form stable implants through axillary incision. The KAABS gathered and analyzed the concepts of Korean plastic surgeons who have experienced transaxillary breast augmentation with anatomic form stable implants. The KAABS requested them of their concepts of 9 basic categories: entrance dissection, pocket dissection, lubricant, inserting aids, skin protector, inserting direction, suction drainage, dressing, compression garment, and their key considerations. Eight expert surgeons suggested their own cutting edge methods of transaxillary breast augmentation with the anatomic form stable implant, however each surgeon should find his or her own method. Authors and KAABS hope that these developing and incomplete concepts help beginners to find their own concepts.
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Humans , Bandages , Breast , Breast Implants , Models, Anatomic , Rupture , Skin , SuctionABSTRACT
Objective To evaluate the results of prosthesis augmentation,relieve suffering patient experience,improve shape and touch of breast.Methods According to design,in dual-plane mammaplasty transaxillary approach with endoscopic assistance,we used soft-tissue expansion before prosthesis,saline volume in expander was the same as prosthesis size at beginning; adjusting expander volume and position,then determined prosthesis size according to expander volume lastly.after intraoperative sustained expansion for 30 to 60 minutes twice prosthes volume,replace expander with prosthesis.Results This method was applied in 120 patients,showing that pain significantly reduced after expansive without use of analgesia pump; complications included that 3 patients appeared seroma and absorbed soon; 2 patients had poor prosthese location,which was adjusted in reoperation; one capsular contracture was repaired later.After 6-months to 2-years follow-up,the results showed that breast was nature and dynamic; satisfactory rate reached to 95 ％.Conclusions In augmentation mammaplastic operation,pre-adoption of an expander can make it easy to adjust the location of prosthesis,to avoid being injured and to determine prosthesis volume by expander injection of saline volume,especially for patient with different size of both breasts.
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Objective Chronic persistent infection following hydrophilic polyacrylamide gel (HPG) injection is one of serious complications in augmentation mammaplasty.It was to search for a perfect treatment for the infection.MethodsA total of 126 patients who accepted HPG injection appeared serious chronic infections.Operation was performed to cut out the HPG and necrotic tissues.The cavities were repeatly washed with negative pressure drainage to control the infection.ResultsAll the symptoms were relieved one to 3 weeks after the treatments in 126 cases.The examination showed that no visible HPG and infection remained in the cavity.No defects existed in the breast and chest wall.ConclusionsFor this infection,the best therapy is to remove the pathologic tissue by surgery and to efficiently control the infection with medication.
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PURPOSE: The sunken chest deformity without breast asymmetry is not a rare condition encountered in augmentation mammaplasty. Therefore, failure to recognize the deformity and improper surgical plan will lead to a suboptimal result. The authors review the experience of breast augmentation in simple sunken chest patient based on retrospectively collected data. METHODS: From January, 2008 to January, 2009, patients with simple sunken chest underwent endoscopic submuscular augmentation mammaplasty through axilla, using silicone implants. Patient demographics were queried and outcomes were assessed. RESULTS: Eleven patients (22 breasts) were followed up for 8.2 months after surgery. Sunken chests were augmented with implant size of approximately 248.9 cc (range: 213~286 cc) and contralateral chest with 211.4 cc (range: 180~235 cc). Simultaneous camouflaging the chest wall depression with breast augmentation resulted in good aesthetic outcome. All of the patients were satisfied with the surgery. There were no complications among all patients. CONCLUSION: We have demonstrated proper surgical planning with precise implant selection to optimize results in patients with small breast and simple sunken chest. Even though asymmetry still remains after the operation, it is still considered as acceptable.
Subject(s)
Female , Humans , Axilla , Breast , Congenital Abnormalities , Demography , Depression , Mammaplasty , Retrospective Studies , Silicones , Thoracic Wall , ThoraxABSTRACT
Objective To explore the indication of implant prosthesis immediately after removing polyacrylamide hydrogel for augmentation mammaplasty. Methods MRI and pathologic examinations were made in 226 patients with the postoperative complications of augmentation mammaplasty by injecting polyacrylamide hydrogel and with the specific conditions in operation to analyze the possibility of implant prosthesis while removing polyacrylamide hydrogel. Based on MRI examination, physical examination and specific conditions in operation, we chosen 61 cases who requested for implant prosthesis while removing polyacrylamide hydrogel. Results The patients who did the operation for simply removing polyacrylamide hydrogel recovered well and symptoms such as pain, sclerosis, mass and others disappeared almostly; the patients who did implanting at the same time were satisfied with the breast shape and had no side-effect occured. Conclusion With MRI examination, physical examination and specific conditions in operation, it can achive good effects to do implanting immediately after removing polyacrylamide hydrogel for those suitable and willing to implant prosthesis.
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PURPOSE: Transaxillary and periareolar incision in augmentation mammaplasty has risks of injury to branches of intercostal nerves that lead to sensory loss of upper inner arm and nipple. The aim of study was to compare the incidence of sensory loss between two groups according to incision method. METHODS: One hundred seventy one cases that received transaxillary or periareolar subpectoral breast augmentation at the M.D. Clinic from Jan. 2006 to Jul. 2007 were evaluated for sensory loss of upper inner arm and nipple. The cases were divided into transaxillary (118 cases, 69%) and periareolar group (53 cases, 31%). The type of sensory loss was divided into temporary and permanent. The postoperative follow-up periods were from 7 to 22 months (mean: 8.5 months). RESULTS: In cases of upper inner arm, results were as follows; temporary sensory loss in 9 cases (7.6%) and permanent in 2 cases (1.7%) in the transaxillary incision group and, temporary sensory loss in 1 case (1.9%) and no permanent sensory loss in the periareolar incision group. There is no statistical difference between the two groups for permanent sensory loss (P=0.340). In cases of nipples, results were as follows; temporary sensory loss in 26 cases (22%) and permanent sensory loss in 12 cases (10.2%) in the transaxillary incision group, and temporary sensory loss in 12 cases (10.2%) and permanent sensory loss in 3 cases (5.7%) in the periareolar incision group. There was no statistical difference between two groups (P=0.335). CONCLUSION: There was no statistical difference in sensory loss of upper arm and nipple between transaxillary and periareolar approach after subpectoral augmentation mammaplasty.
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Female , Arm , Breast , Follow-Up Studies , Incidence , Intercostal Nerves , Mammaplasty , NipplesABSTRACT
PURPOSE: Introduction of the mammary implant through the abdominal route has been well known since late 1960s, but the use of transabdominal route for contralateral breast augmentation in transverse rectus abdominis musculocutaneous(TRAM) flap breast reconstruction patients has not been reported in Korean literature. The authors report their experience with technical points as well as the selection of the appropriate patients. METHODS: Simultaneous contralateral augmentation mammaplasty through transabdominal route was performed in 11 patients who underwent TRAM breast reconstruction from August 2003 to May 2008 with a mean follow up of 27 months. The pocket was created under direct vision: 3 subglandular, 7 subpectoral, and 1 dual plane was dissected. Eight saline and 3 silicone gel implants were used with an average volume of 165 cc. RESULTS: There were no complications such as infection, hematoma, implant displacement, and capsular contracture. The results were well maintained throughout the follow-up period. CONCLUSION: Transabdominal route could be recommended in selected patients for contralateral augmentation in TRAM breast reconstruction.
Subject(s)
Female , Humans , Breast , Contracture , Displacement, Psychological , Follow-Up Studies , Hematoma , Mammaplasty , Rectus Abdominis , Silicone GelsABSTRACT
PURPOSE: Autolougous fat grafting to the breast for cosmetic enlargement remains controversial because the efficacy and the complications due to fat necrosis are unclear. METHODS: Ten cases who underwent autologous fat grafting to the breast for enlargement and visited author's clinic from October 2006 to March 2008 were evaluated retrospectively. Mammography, ultrosonography, culture, cytology, operative findings and results were reviewed for each cases. RESULTS: The study group consisted of 7 cases for additional augmentation mammaplasty, 1 case for breast abscess, 2 cases for breast examination. Two of 7 augmentation cases had multiple palpable masses. One of 2 cases for breast examination had fat grafts 20 months ago and have suffered from painful huge masses especially on exercise. One case with abscess had fat graft 4 months ago and have suffered from painful reddish swelling. On mammography of 9 cases except 1 breast abscess, malignancy could not be excluded in 2 cases because of bizarre forms of multiple microcalcifications. On ultrasonography of 8 cases, there were ill defined hypoechoic masses in 2 cases which needed additional cytology for rule out malignancy. There were implant puncture in all 2 cases with silicone implants, and in case with abscess, there were S. epidermidis in culture. Among 7 augmentation mammaplasty cases, removal of fat necrosis was performed simultaneously in 1 case with severely palpable masses but postoperative seroma formation and capsular contracture occurred. CONCLUSION: Autologous fat grafting for breast augmentation can make masses, abscess and microcalcifications on mammography due to fat necrosis which compromise breast cancer detection. Additional study is necessary to evaluate the efficacy of fat stem cell grafts as an alternative to traditional method.
Subject(s)
Female , Abscess , Breast , Breast Neoplasms , Contracture , Cosmetics , Fat Necrosis , Mammaplasty , Mammography , Punctures , Retrospective Studies , Seroma , Silicones , Stem Cells , TransplantsABSTRACT
With the rising of augmentation mammaplasty, deflation of implant is increasing. So authors investigated and analyzed on patients who were treated due to deflation. Subjects were 15 patients(16 breasts) from September 1995 to March 2006. Authors had been investigated and analyzed the method of augmentation mammaplasty, types of breast implant, duration until deflation occurred, duration to reoperation, reoperation method and patient satisfaction. The follow-up period after reoperation was 33 months. The methods of augmentation mammaplasty were 13 patients(13 breasts) for transaxillary approach, 1 patient(1 breast) for inframammary approach and 1 patient(2 breasts) for periareolar approach. Location of implants was subpectoral plane. 2 patients(2 breasts) had silicone bag and 13 patients(14 breasts) had saline bag. The average time elapsed to deflation was 36 months. The elapsed time to reoperation were within 1 month(12 breasts), 4 months(1 breast), 6 months(1 breast), 7 months(1 breast) and 10 months(1 breast). The removal of mammary bag was performed only for 3 patients(3 breasts) and reaugmentation was performed for the rest of them, 12 patients(13 breasts). In reaugmentation, most of patients received the previous approach again. In case of reoperation, partial capsulectomy was performed. There were no patients of deflation. The patients had found good satisfaction in our management.
Subject(s)
Female , Humans , Breast Implants , Follow-Up Studies , Mammaplasty , Patient Satisfaction , Reoperation , SiliconesABSTRACT
PURPOSE: The transaxillary approach for breast augmentation has been advocated for patients and surgeons for several decades. However, this blind technique had many disadvantages including, traumatic dissection, difficult hemostasis, displacement of implants, and ill-defined asymmetrical location of inframammary crease. In the present study, the precise endoscopic electrocautery dissection was applied to eliminate the limits of blunt dissection throughout the procedures. METHODS: From December 2006 to December 2007, a total of 103 patients with an average age of 29.5 years underwent endoscopic assisted transaxillary dual plane augmentation mammoplasty. The mean implant size was 243 cc with the range between 150 and 350cc. Through a 4cm axillary incision, electrocautery dissection for submuscular pockets was carried out under the endoscopic control. The costal origin of pectoralis muscle was completely divided to expose subcutaneous tissue and to make type I dual plane. RESULTS: Using the endoscopic dissection, we achieved good aesthetic results including a short recovery period, less morbidity, and symmetrical well-defined inframammary crease. Type I dual plane procedure could support the consistent inframammary fold shape and be applied to most patients without breast ptosis. Minor complications did not occur, however, four major complications of capsular contracture occurred. CONCLUSION: In contrast to the era of the blind techniques, endoscopic assisted transaxillary dual plane breast augmentation can now be performed effectively and reproducibly. With Its advantage, the axillary application of endoscopy for augmentation mammaplasty is useful to achieve the optimal cosmetic outcomes.
Subject(s)
Female , Humans , Breast , Contracture , Cosmetics , Displacement, Psychological , Electrocoagulation , Endoscopy , Hemostasis , Imidazoles , Mammaplasty , Nitro Compounds , Pectoralis Muscles , Subcutaneous TissueABSTRACT
PURPOSE: The major drawback of submuscular augmentation of the ptotic breast is a "double-bubble" deformity. If a traditional mastopexy is added to correct the ptosis, there would be additional scars. This article describes simultaneous periareolar mastopexy with dual plane or subfascial breast augmentations. METHODS: A series of 81 patients with grade I or II ptosis underwent the procedure from 1999 to 2005. Out of these, dual plane augmentation was done in 71 cases and subfascial plane in 10. After periareolar skin excision, an incision is made perpendicularly down to the fascia of pectoralis. At the lower pole, all breast implants are inserted into the subfascial plane. In case of upper pole thickness of above 20mm, we inserted the implant into the subfascial plane, whereas below 20mm, we inserted that into the submuscular plane. RESULTS: No major complications were noted and patients' satisfactory score was high. This technique avoids the "double-bubble" deformity and leaves a minimal periareolar scar. CONCLUSION: Simultaneous periareolar mastopexy/ breast augmentation is useful for correction of the ptotic breast, increasing the volume of breast and providing the natural breast shape with minimal scars. We consider that subfascial plane augmentation with periareolar mastopexy to be an alternative for cases with breast upper pole thickness of at least above 20mm.
Subject(s)
Humans , Breast , Breast Implants , Cicatrix , Congenital Abnormalities , Fascia , SkinABSTRACT
PURPOSE: The major drawback of submuscular augmentation of the ptotic breast is a "double-bubble" deformity. If a traditional mastopexy is added to correct the ptosis, there would be additional scars. This article describes simultaneous periareolar mastopexy with dual plane or subfascial breast augmentations. METHODS: A series of 81 patients with grade I or II ptosis underwent the procedure from 1999 to 2005. Out of these, dual plane augmentation was done in 71 cases and subfascial plane in 10. After periareolar skin excision, an incision is made perpendicularly down to the fascia of pectoralis. At the lower pole, all breast implants are inserted into the subfascial plane. In case of upper pole thickness of above 20mm, we inserted the implant into the subfascial plane, whereas below 20mm, we inserted that into the submuscular plane. RESULTS: No major complications were noted and patients' satisfactory score was high. This technique avoids the "double-bubble" deformity and leaves a minimal periareolar scar. CONCLUSION: Simultaneous periareolar mastopexy/ breast augmentation is useful for correction of the ptotic breast, increasing the volume of breast and providing the natural breast shape with minimal scars. We consider that subfascial plane augmentation with periareolar mastopexy to be an alternative for cases with breast upper pole thickness of at least above 20mm.
Subject(s)
Humans , Breast , Breast Implants , Cicatrix , Congenital Abnormalities , Fascia , SkinABSTRACT
Ideal results of augmentation mammaplasty consist of symmetry, natural shape, soft feeling and inconspicuous scar. In addition, patient's preferences about size and shape should be included. Static implants could not perfectly satisfy patients' desires for size and shape, but expandable implants enable to change the volume after the operation. From September 2001 to September 2004, 76 patients(150 breasts) underwent breast augmentation using permanent expandable implant. The procedure was unilateral in 2 women and bilateral in 74 women. Age ranged from 19 to 50 years(mean, 29 years). Fifty nine patients underwent simple augmentation mammaplasty, 7 patients were corrected of their severe asymmetry, 2 patients with the congenital breast deformity underwent mammaplasty using this, and 2 patients who had undergone unilateral mastectomy were reconstructed of their breasts using expandable implant. There were no definite complications such as capsular contracture, implant rupture, asymmetry. And there reported little dissatisfaction about the size. The permanent expandable implants might be good alternatives in cases of ordinary breast augmentation as well as tissue deficient patients, asymmetry, congenital anomaly, and breast reconstruction.
Subject(s)
Female , Humans , Breast , Cicatrix , Congenital Abnormalities , Implant Capsular Contracture , Mammaplasty , Mastectomy , RuptureABSTRACT
Infection following insertion of a breast implant is relatively uncommon, with an overall incidence of less than 4 percent, but can be devastating. Although its management options may be antibiotic therapy along with active surgical regimen like drainage, mechanical irrigation, debridement and implant removal, the efficacy of aforementioned therapeutic regimen is unclear in some cases, thus can be challenging. In particular cases of being chronic and refractory to therapy, spreading of infection which was originally localized in the periprosthetic space-over adjacent tissues by an aggressive curettage at the early stage appears to play a major role. Months elapse before a complete resolution of the infection, and it can also cause serious physical and mental issues in patients. Based on clinical and operative findings in four cases of a chronic, refractory and recurrent periprosthetic infection following an aggressive initial debridement and curettage, we suggest that surgeon should be watchful against debridement and curettage at the early stage of infection and pay special attention to make an accurate and limited curettage using endoscopy.
Subject(s)
Female , Humans , Breast Implants , Curettage , Debridement , Drainage , Endoscopy , Incidence , MammaplastyABSTRACT
Objective To investigate complications of polyacrylamide hydrogel injection for augmentation mammaplasty and treatment of the complications so as to reduce the suffering of the patients to the lowest degree. Methods The clinical signs of 8 cases who had complications after polyacrylamide hydrogel injection for augmentation mammaplasty were studied. Results The complications of 8 cases included bleeding, hard nodule, aseptic inflammation and difficulty to clean the filling material completely from the normal tissue of human body. Conclusions The complications mainly result from improper procedure during the operation. Cautious attitude should be taken in the clinical application of this material and it should not be abused. Furthermore, the standard and appropriate method and technique for the operation should be employed.
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Objective To study the histologic characteristics of the capsule of breast implant. Methods Four miniprostheses were seperatelly implanted in four positions beneath the panniculus carnosus muscle in 30 rabbits. After 3 weeks, 1, 2, 3, 4, 6 and 12 months, capsular histology examination and the assay of capsular collagen content and type were performed. Results ⑴ Capsule was divided into two layers: the inner layer was dense and the outer loose connective tissues. Collagen component was more, cellular component was less and capsule was thicker (P0.05). ⑵ Capsular collagen content increased gradually in 3 months (P0.05). ⑶Collagen fibers were the most component, reticular fibers were second and elastic fibers were least. After 3 months, elastic fibers decreased, and collagen and reticular fibers became full layer gradually. ⑷ Capsular collagen type I in the capsule was gradually increased and type III decreased before 3 months. There were no significant changes after 3 months. Conclusions Histology of the implant capsule is similar to that of scar and the result of wound healing around implant.