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Objective:To evaluate incision scars of transaxillary breast augmentation by different methods of scar assessment.Methods:A retrospective study was carried out on 30 patients (age range 20 to 50 years, with mean age of 32 years) who underwent endoscopic assisted transaxillary type Ⅰ dual plane breast implant augmentation by a same surgeon from August 2014 to November 2016. Scars were estimated by 3 methods which included Vancouver Scar Scale (VSS), Visual Assessment Scale (VAS) and patients' questionnaire.Results:VAS score for left side scars ranged from 0 to 8 and the median was 1. VAS score for right side scars ranged from 0 to 8.3 and the median was 1. A total of 48 scars were scored in the 0-2 point range, representing 80% of the 60 total. VSS score for left side scars ranged from 0 to 11.6 and the median was 0.8. VSS score for right side scars ranged from 0 to 11.3 and the median was 1.2. A total of 46 scars were scored in the 0-2 point range, representing 76.7% of the total 60 breats. The scores between VSS and VAS had significant statistical differences ( P<0.001). 80.0% of our patients regarded scars as unconspicuous or basically invisible in our questionnaire. Conclusions:The majority of transaxillary incision scars recover in favorable status with high patients satisfactory rate. VAS is a practical tool for evaluating transaxillary incision scars. The VSS score is not equivalent to the VAS score when grading scars only by photos.
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Objective:To improve the multiple-link operation efficiency, effect and satisfaction of transaxillary dual-plane breast augmentation by optimizing and upgrading the configuration of auxiliary tools.Methods:From January 2019 to May 2021, breast augmentation was performed in 130 female patients (aged 32±8 years) in the Cosmetic and Plastic Center of the First Affiliated Hospital of Harbin Medical University. The study was conducted among 63 patients who were eligible for the criteria of high configuration surgery. 67 patients underwent standard configuration surgery. The average operation time, intraoperative blood loss, drainage volume (24 hours after operation), postoperative visual analog scale (VAS) pain score and satisfaction were statistically analyzed.Results:The data of high configuration method and standard configuration method were compared as follows: average operation time was (78.6±12.2) min / (93.1±12.1) min ( t=15.73, P<0.05); the average intraoperative blood loss was (3.1±1.0) ml / (14.4±3.5) ml ( t=13.83, P<0.05); the drainage volume (24 hours after operation) was (37.2±8.2) ml / (61.4±10.9) ml ( t=20.82, P<0.05); the pain score on the first day after surgery was (6.1±1.7) points / (7.5±1.6) points ( t=8.57, P<0.05). The overall satisfaction rate was 97.1±1.6 / 95.6±2.0 ( t=5.58, P>0.001), at 6 months after operation. No severe complications were found during the follow-up period, such as capsular contracture, hematoma, infection and double bubble deformity. Conclusions:The use of ultrasonic knife with delivery bag is an effective optimization and upgrade of the endoscopic assisted transaxillary dual plane breast augmentation. The advantages of this method are obvious, highly efficient, safe, effective and satisfactory. It is worthy of clinical application and promotion.
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Resumen Antecedentes: La cirugía de aumento mamario con lipoinjerto se ha incrementado debido a que evita usar prótesis. Es utilizado para aumentos moderados con fines estéticos, no retarda el diagnóstico de cáncer ni aumenta el riesgo de sufrirlo. Objetivo: Revisar nuestra experiencia en aumento mamario estético con lipoinjerto, en una sesión y con seguimiento superior a un año. Materiales y Método: Se diseñó una cohorte prospectiva de mujeres. Se excluyeron aquellas con alteraciones congénitas, mesenquimopatías y fumadoras. La lipoinyección se efectuó con principios de Coleman. Para la medición del volumen mamario preoperatorio se utilizó la aplicación Breast-V. Volumen de aumento, tasa de retención y tasa de aumento fueron calculados. Resultados: 73 pacientes fueron lipoinjertadas, 35 superaron seguimiento a un año. Volumen mamario inicial fue 219,5 ± 44,1 cc. Volumen de aumento fue 99,9 ± 29,8 cc, tasa de retención grasa injertada 41,4%, tasa de aumento del volumen mamario 48,1%. 41 pacientes presentaron imágenes posoperatorias: quistes 15 pacientes (36,6%); necrosis grasa 2 pacientes (4,9%); macrocalcificaciones 8 pacientes (19,5%); microcalcificaciones 1 paciente (2,5%), cuya biopsia fue negativa para malignidad. Discusión: El lipoinjerto mamario es un procedimiento seguro, con resultados adecuados cuando se realiza en una sesión y por el mismo cirujano, siguiendo principios de Coleman. El aumento porcentual es el índice más significativo para evaluar su éxito. Conclusiones: Lipoinyección mamaria en una sesión es una técnica segura que logra aumento moderado del volumen mamario. Es útil para aumentos moderados o corrección de asimetrías leves. No hay evidencia de que interfiera con el diagnóstico precoz del cáncer de mama.
Background: Lipograft breast augmentation has increased due to avoidance of prosthetics. It is used for moderate increases for aesthetic purposes, it does not delay the diagnosis of cancer or increase the risk of suffering it. Aim: To review our experience in cosmetic breast augmentation with lipograft, in one session and with a follow-up of more than one year. Materials and Method: A prospective cohort of women was designed. Those with congenital alterations, mesenchymopathies and smokers were excluded. Lipoinjection was carried out with Coleman's principies. The Breast-V application was used to measure preoperative breast volume. Volume of increase, retention rate and rate of increase were calculated. Results: 73 patients were lipografted, 35 had a one-year follow-up. Initial breast volume was 219.5 ± 44.1 cc. Volume increase was 99.9 ± 29.8 cc, grafted fat retention rate 41.4%, breast volume increase rate 48.1%. 41 patients presented postoperative images: cysts 15 patients (36.6%); fat necrosis 2 patients (4.9%); macrocalcifiations 8 patients (19.5%); microcalcifiations 1 patient (2.5%), whose biopsy was negative for malignancy. Discussion: The mammary lipograft is a safe procedure, with adequate results when performed in one session and by the same surgeon, following Coleman principles. The percentage increase is the most significant index to evalúate your success. Conclusions: Breast lipoinjection in one session is a safe technique that achieves a moderate increase in breast volume. It is useful for moderate magnification or correction of slight asymmetries. There is no evidence that it interferes with the early diagnosis of breast cancer.
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Humans , Female , Surgery, Plastic/methods , Adipose Tissue/transplantation , Mammaplasty/methods , Injections/methods , Surgery, Plastic/rehabilitation , Follow-Up Studies , Mammaplasty/rehabilitationABSTRACT
Objective:To investigate the causes and treatment of implant malposition after breast augmentation surgery.Methods:A retrospective study was conducted to investigate the patients with implant malposition after breast augmentation treated or consulted in our department from January 2000 to December 2020. A total of 95 breasts in 74 patients were treated during the period. The age of the patients was from 19-50 years, with the mean of 31.2 years. Causes of these complications were analyzed and the patients were managed in different ways according to the times after primary breast augmentation.Results:Twenty-one malposition breasts occurred within one week after primary surgery, and 17 breasts were successfully treated with manual reduction and fixation. 4 breasts were treated with operation after failed with manual reduction. The patients had good and bilateral symmetric breast morphology during the 6 months follow-up after the second operation. 25 malposition breasts were treated from one week to one month after primary surgery. Reoperation was performed through the original incision, separating the adhesive cavity to reposition the implant. Those patients were successfully treated. No re-occurrence was detected at 6 months follow-up after treatment. 49 malposition breasts were treated more than 3 months after primary surgery. Excessive capsule wrapping the shifted implant was removed to recreate a fresh wound while the adhesive cavity was separated to reset the implant. Bandage fixation was necessary. 7 implants were exchanged. 2 breasts were over corrected and re-operated successfully.Conclusions:The causes of implant malposition at different time after breast augmentation are various. Different methods can be used for effective treatment.
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Background@#In 716 Mongolian patients who had breast augmentation surgery at Perfect Clinic during 18 years. The purpose of this study evaluates Mongolians predictors of early and late outcome after primary breast augmentation surgery.@*Aims of study@#In this study, we aimed to clarify predictors of early and late outcome after breast augmentation surgery.@*Methods@#We selected patients who underwent breast augmentation implant surgery between 1999 and 2017. Development of hematoma was chosen for measure of early outcome and capsule contracture was chosen for measure of late outcome. Multivariable Cox proportional hazard regression and Kaplan-Meier estimations were used to clarify independent relationship between possible predictors and outcomes.@*Results@#A total of 716 patients were chosen and mean age was 32±7 years old. Hematoma was occurred in 43 patients (6%) and median time to hematoma was 3 days (IQR 1; 7).). According to the univariable analysis, every 1 year experience was associated with 9% decreased risk of hematoma development. (HR=0.91, 95% CI 0.84-0.99, p<0.05). Finally, Kaplan-Meier estimation was showed that hematoma free survival is higher in more experienced years and patients who had subpectoral muscle.(log rank p<0.01 and p<0.001, respectively). Capsule contracture was occurred in 38 patients (5.3%) and median time to capsule contracture was 10 months (IQR 3; 27). According to the univariable analysis, every 1 year increase of surgical experience is related to 9% decreased risk of capsule contracture (HR=0.81, 95% CI 0.75-0.88, p<0.001), and more textured implant type is associated with less capsule contracture (HR=0.47, 95% CI 0.34-0.66, p<0.001). </br> Multivariable hazard regression was revealed that implant type (HR=0.55, 95% 0.33-0.90, p<0.05) and surgical time (HR=1.00, 95% CI 1.00-1.01, p<0.001) were independently associated with capsule contracture after breast augmentation surgery (Table 4). Kaplan-Meier estimation was determined that capsule contracture free survival is higher in more experienced years and patients who had more textured implant and subpectoral muscle implant (log rank p<0.001, p<0.001 and p<0.001, respectively).@*Conclusions@#For breast augmentation surgery, implant type is independent predictor of capsule contracture and surgical experience is predictor for both hematoma and capsule contracture. Therefore, above mentioned predictors should be considered to prevent complications related to breast augmentation implant surgery.
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Objective:To explore the effect of decision-making assistance during the implantation selection of breast augmentation patients to provide a reference for improving decision-making aids.Methods:From June 2018 to June 2020, the decision-making assistance programs were used in the Department of Plastic and Reconstructive Surgery, Shanghai Ninth People＇s Hospital for prosthesis selection in 51 breast augmentation female patients, aged 23 to 42 years, with an average of 31 years old. The BREAST-Q scale was applied to assess the postoperative results of augmentation patients. Postoperative breast satisfaction was also evaluated by the physicians.Results:With decision-making assistance, breast augmentation patients＇ satisfaction with breasts was (80.27±11.45) points, satisfaction with surgical results (83.41±12.29) points, social and psychological status scores (87.24±7.62) points, and sexual life status scores (85.49±7.90) points, physical condition score (73.94±8.98) points. There was no statistical difference in the scores of breast size between physicians and patients ( P>0.05). In the satisfaction score and total score of breast shape and feeling, physicians＇ scores were higher than patients＇ self-report scores, and the difference was statistically significant ( P<0.05). Conclusions:The patient self-reported postoperative outcomes are at a high level under the application of decision aid program. We can further improve the decision aid program for breast augmentation patients, adjust patient＇s surgical expectation, and realize shared decision making.
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Objective:To study the rate of capsule contracture after operation of the textured surfaces breast implants and the smooth surfaces breast implants, to provide evidence for plastic surgeons to select the type of breast implants during breast augmentation.Methods:This study started from January 2018 to May 2019. Chinese and English databases including Wanfang Science and Technology Periodical Full-text Database, VIP Chinese Science and Technology Periodical Full-text Database (VIP) and CNKI, PubMed, Cochrane Library, Web of Science, Science Drirect Online were searched by computer. Some relevant studies were collected for this meta-analysis.Results:We identified 9 studies including a total of 13165 subjects for the meta-analysis. The OR value of the study was 0.43 (95% CI: 0.35, 0.51), and the incidence rate of capsule contracture in the experimental group was lower than that in the control group. In cumulative meta-analysis and sensitivity test, the conclusion was stable. And there was no publication bias found by Egger regression test. Conclusions:The textured surfaces breast implants are better than the smooth surfaces breast implants in terms of incidence rate of capsule contracture after augmentation mammoplasty.
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Objective:To investigate the preliminary effects of sub-pectoral fascial breast augmentation and reconstruction.Methods:Six patients (10 breasts) of mammary dysplasia, mastatrophy, prophylactic mastectomy, unilateral breast defect with contralateral mastatrophy were included in the study from Oct. 2019 to July 2021. The mean patient age was 29 years (range, 20 to 35 years). All the textured and smooth cohesive gel implants were inserted under pectoralis major fascia by endoscopic-assisted, incisions were including axillary, around areola and inferior mammary fold approaches. The prophylactic mastectomy cases were performed nipple sparing mastectomy and sub-pectoral fascial breast restoration with implants. The fat and fascia tissue were well reserved to give a satisfying coverage of the appropriate implant. Negative pressure drainage and moulding dressing were used after the surgery.Results:Ten breast augmentation and restoration with a mean implant size of 200 cc (range, 180-300 cc). Less immediate postoperative pain and bleeding were reported. Patients were followed up for an average of 10 months (range, 6 to 21 months). There were no cases of major malpositions, double-bubble and bottom out symptoms. The overall outcome was with better symmetry and satisfaction with time passed by, and no secondary surgical procedures needed.Conclusions:Primary and satisfactory results have been obtained in subfascial breast augmentation and restoration for indications. With the endoscopic-assisted accurate pectoral fascial dissection, and well reserved soft tissue coverage, this technique could avoid the pectoralis major muscle ablation and keep the advantages of sub-glandular plane.
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Objective:To explore the method and experience of augmentation mammoplasty with autologous fat transplantation assisted by external expander.Methods:From January 2013 to December 2020, 352 female patients (698 breasts, 346 bilateral and 6 unilateral), aged from 18 to 55 years, with an average age of 41.5 years, were admitted to the Department of Cosmetic Surgery, Beijing Jingmei Medical Cosmetology Clinic. From 1-28 days before surgery, autologous fat transplantation was performed after wearing the dilator, and postoperative wearing of the dilator lasted from 1 to 24 months, with an average of 3.5 months.Results:The volume of fat transplantation per breast ranged from 150 ml to 460 ml, with an average of 320 ml. No obvious postoperative complications such as fat liquefaction, infection, intramammary induration and fat embolism were observed, and the postoperative appearance was lasting. The postoperative follow-up was conducted from 6 months to 7 years, and patient postoperative satisfaction rate reached 84.9% and doctors＇ satisfaction after surgery reached 82.1%.Conclusions:Augmentation mammoplasty with autologous fat transplantation assisted by external expander can effectively improve the appearance of breast morphology and contour defects and increase the survival rate of fat transplantation, which is worthy of clinical application.
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Objective:To explore whether botulinum toxin A (BTX-A) can improve the retention rate of fat transplantation in fat breast augmentation.Methods:Each patient was divided into control side and experimental side according to the random number table in 14 patients studied. The experimental group received autologous fat and BTX-A combined transplantation on both sides of the breast, while the control side only received autologous fat transplantation. The fat was added with the same volume of normal saline as BTX-A in the control group. All patients were followed up and the effects of BTX-A were evaluated objectively via the comparison of the remained bilateral fat graft volumes that were obtained through a digital three-dimensional reconstructions technique. Moreover, the improvement of each breast appearance and complication were assessed by the physician and patients who were blinded to the recipient treatment assignment.Results:The outcome of the fat breast augmentation was evident for both groups at the follow-up with no evidence of fat embolism, vascular/nervous injury, infection and prolonged bruising. In one of the 14 patients (control group), fat liquefaction necrosis occurred in one side of the breast; after active treatment, it returned to normal, and three patients had different degrees of mass. The analysis on the three-dimensional reconstruction data and the assessments from both the physicians and patients showed significant differences in the fat graft retention volume between the BTX-A group (51.10±20.56)% and the control group (33.06±14.77)%. Nevertheless, there was no significant difference in the incidence of complications between the two sides.Conclusions:Autogenous fat breast augmentation is safe and effective. This study result has shown that BTX-A can significantly improve the retention rate of fat transplantation but cannot reduce the incidence of complications.
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Abstract Background and objectives: PECS I block was first described for surgery involving the pectoralis muscles. No randomized clinical trial has been conducted on surgeries that directly involve these muscles, such as subpectoral breast augmentation. We hypothesized that PECS I block would decrease pain in the postoperative period in this population. Methods: This was a randomized, double-blind, placebo-controlled trial in women undergoing subpectoral breast augmentation surgery. PECS I block was performed using 0.4 mL.kg-1 of 0.9% saline on one side and bupivacaine (0.25%) on the other side, each patient being her own control. Numeric Rating Scale (NRS) pain scores (0 - 10) were measured at rest and during movement. The primary outcome was pain score at rest 30 minutes after arrival in the PACU. To detect a clinically significant difference of 50% in pain reduction, 14 volunteers were enrolled (power of 90% and alpha < 0.05). Results: In the PACU, three patients had no difference in pain between sides, five had reduced pain on the placebo side, and six had reduced pain on the bupivacaine side. In the bupivacaine group, pain scores at rest at 5, 30 and 60 minutes and 24 hours were 4.89 (4.23 - 5.56; mean 95% CI), 3.75 (3.13 - 4.37), 3.79 (2.93 - 4.64), and 2.29 (1.56 - 3.01), respectively, whereas in the placebo group, they were 4.96 (4.32 - 5.60), 4.00 (3.50 - 4.49), 3.93 (3.12 - 4.73), and 2.29 (1.56 - 3.01), respectively. Conclusions: PECS I block in patients undergoing breast augmentation surgery does not provide better pain relief than placebo. Therefore, the indications for PECS I block in breast augmentation surgery should be reconsidered.
Resumo Justificativa e objetivos: O bloqueio PECS I foi descrito pela primeira vez para cirurgia envolvendo os músculos peitorais. Nenhum estudo clínico randomizado foi realizado em procedimentos envolvendo diretamente os músculos peitorais, como a mamoplastia de aumento submuscular. Nossa hipótese foi de que o bloqueio PECS I diminuiria a dor pós-operatória nessa população. Método: Realizamos estudo randomizado, duplo-cego, controlado por placebo em mulheres submetidas à mamoplastia de aumento submuscular. Realizamos o bloqueio PECS I com 0,4 mL.kg-1 de solução salina a 0,9% de um lado e bupivacaína (0,25%) do outro lado, sendo cada paciente seu próprio controle. Os escores da Escala de Avaliação Numérica (EAN) de dor (0 - 10) foram obtidos em repouso e durante movimento. O desfecho primário foi o escore de dor em repouso 30 minutos após a chegada à SRPA. Para detectar uma diferença clinicamente significante de 50% na redução da dor, 14 voluntárias foram incluídas (poder de 90% e alfa < 0,05). Resultados: Na SRPA, três pacientes não apresentaram diferença na dor entre os lados, cinco relataram menos dor no lado do placebo e seis, menos dor no lado da bupivacaína. No grupo bupivacaína, os escores de dor em repouso aos 5, 30 e 60 minutos e 24 horas foram 4,89 (4,23 - 5,56; IC médio 95%), 3,75 (3,13 - 4,37), 3,79 (2,93 - 4,64) e 2,29 (1,56 - 3,01), respectivamente, enquanto no grupo placebo foram 4,96 (4,32 - 5,60), 4,00 (3,50 - 4,49), 3,93 (3,12 - 4,73) e 2,29 (1,56 - 3,01), respectivamente. Conclusões: O bloqueio PECS I em pacientes submetidas a mamoplastia de aumento não oferece melhor alívio da dor do que o placebo. Portanto, as indicações para bloqueio de PECS I na cirurgia de aumento de mama devem ser reconsideradas.
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Humans , Female , Adult , Pain, Postoperative/prevention & control , Bupivacaine/administration & dosage , Breast Implantation/methods , Nerve Block/methods , Pain Measurement , Double-Blind Method , Anesthetics, Local/administration & dosageABSTRACT
Background@#Autologous fat grafting has gained popularity in breast augmentation. Various methods can be used to estimate the volume retention rate. This systematic review aimed to establish whether the type of method used for measuring breast volume is a factor that influences the reported volume retention rate.@*Methods@#Studies were identified using the electronic databases PubMed, Embase, Cochrane Central Register of Controlled Trials, and Web of Science from inception of the database up to February 2019. Articles describing autologous fat grafting for breast augmentation were selected based on pre-determined inclusion and exclusion criteria. The characteristics of the included studies were summarized, and the reported volume retention rate from the studies was compared. A quality assessment of all included articles was performed using the methodological index for non-randomized studies criteria.@*Results@#A total of 618 articles were identified, of which 12 studies, with a total of 1337 cases, were eligible. The retention rate of injected adipose tissue varied when the method of fat grafting and volume analysis used were both the same, as well as when the method of fat grafting was the same but the method of volumetric evaluation used was different.@*Conclusions@#Currently, the tools available for estimating the volume retention rate come with limitations. In order to objectively evaluate the percentage of graft retention, a standard protocol that applies to the different methods should be established in the future.
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Objective: To explore the risk factors related to periprosthetic infection after breast augmentation, and to provide a basis for reducing the risk of postoperative infection. Methods: A total of 1 056 female patients who underwent breast augmentation between January 2010 and January 2018 were analyzed retrospectively. The patients were 20 to 44 years old (mean, 31.6 years). The body mass index (BMI) was 19.0-31.1 kg/m 2, with an average of 24.47 kg/m 2. According to the periprosthetic infection standard of the United States Centers for Disease Control and Prevention (CDC), the patients were divided into infection group and non-infection group. Age, BMI, diabetes, previous history of immunosuppression, history of smoking, previous history of breast surgery, previous history of mastitis, combined with active dermatitis, surgical approach, the type and shape of breast prosthesis, implant in the different layers, combined with mastopexy, operation time, postoperative antibiotic time, postoperative breast crash, and postoperative potential infection surgery were analyzed by univariate analysis. The influencing factors of prosthetic infection were screened by logistic regression. Results: Periprosthetic infection occurred in 60 cases after operation, and the infection rate was 5.68%. Among them, 11 cases were acute infection, 33 cases were subacute infection, 16 cases were delayed infection, and 20 cases were positive in bacterial culture. Postoperative breast crash occurred in 114 cases. Univariate analysis showed that diabetes, previous history of immunosuppression, history of smoking, previous history of mastitis, postoperative breast crash, postoperative potential infection surgery, and combined with breast suspension were the influencing factors of postoperative periprosthetic infection ( P<0.05). Multivariate analysis showed that diabetes, history of smoking, and postoperative breast crash were the risk factors of periprosthetic infection ( P<0.05). Conclusion: Diabetes, smoking, and postoperative breast crash are the risk factors of periprosthetic infection after breast augmentation.
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Objective To study the pathological mechanism of aseptic necrosis of breast tissue after long-term breast augmentation injected with polyacrylamide hydrogel (PAHG).Methods We included patients who had no obvious clinical symptoms and underwent surgical removal of the PAHG in our hospital,excluding patients with a history of breast prosthesis implantation.Extracts were collected,and then underwent a careful gross observation and serial sections followed by HE,Mallory,and toluidine blue staining,to observe the histological structure of collagen fibers and inflammatory cells.Immunohistochemistry for CD31 and a-smooth muscle actin (a-SMA) antibody was used to further identify vascular endothelial cells and vascular smooth muscle cells,respectively.Analysis of the correlation between injection time and the incidence of different pathological changes were done.Results We included 22 females (mean age 39.14 years,range 22-55 years) who requested surgical removal of the PAHG.The mean duration of PAHG injection was 9.27 years (range 4-14 years).They had no clinical symptoms or only had induration,deformation and displacement.The basic pathological changes of local tissue included foreign body reaction and chronic inflammation,fibrosis and tissue necrosis;and half of the tissue had also histological changes,such as small vascular smooth muscle layer thickening,lumen stenosis,etc.No significant correlation was found between the pathological changes and the duration of the disease and the clinical symptoms.Conclusions Patients with PAHG injection for augmentation mammoplasty can histopathological changes of local tissues even without experiencing discomfort.The tissue necrosis in some patients may be caused by foreign body reaction and inflammatory reaction.It may also be due to local ischemia caused by small vascular smooth muscle hyperplasia,luminal stenosis etc.
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Objective To report our experience of breast augmentation patients with fat grafting.Methods The treatment of 560 patients with fat grafting for breast augmentation was summarized in our hospital from Jan.2011 to Dec.2015.Fat was harvested using low negative pressure liposuction technique with 3-hole blunt cannula (diameter 2.5 mm).The fat was managed using cotton pad for concentration of fat tissue and separating them from fluids,oil,and debris.A diameter 2.5 mm,1-hole blunt cannula was used to place the fat through 3-mm incision on inframammary fold,fat grafting with multi-level and multi-tunnel and multi-point injection ways,regularly taking picture for imaging evaluation.Results All patients were successfully performed with breast augmentation,and no severe complications occurred.Grafted fat volume ranged from 180 to 400 ml (average,235 ml) per breast.Most of women had a significant improvement in their breast size and shape postoperatively,and the breasts were soft and natural in appearance.The patients were followed up for 18-24 months,and the outcome were satisfactory.Conclusions Autologous fat grafting for breast augmentation simplifies the operation procedure with satisfied results (natural breast and body contouring) and avoids the complications of breast prosthetic procedures.
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Objective To compare the coronary incision with the sagittal incision in transaxillary breast augmentation.Methods A total of 60 patients who underwent transaxillary subpectoral breast augmentation with round breast implants were randomly allocated into two groups:Group A (30 patients) received coronary incision,while Group B received sagittal incision.The operative time of implant insertion,the distinction of scar and the repair rate of scar were compared between the two groups.Results The mean operative time of implant insertion in group A was (14.55±3.79)s,and that in group B was (27.38±6.79) s,with statistically significant difference (t =9.03,P＜0.05).But there was no statistical significance in the difference in the degree of scar (x2 =0.26,P＞0.05) or the repair rate of scar (x2=0.35,P＞0.05) between two groups.Conclusions As for the operative time of implant insertion,the coronary incision is better than the sagittal incision.
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Objective To investigate the feasibility and clinical effect of transaxillary dual-plane breast augmentation under endoscope combined with autologous fat transplantation.Methods From January 2015 to December 2015,88 patients who accepted augmentation mammoplasty were divided into control group (from January to June) and observation group (from July to December).Patients in control group only accepted transaxillary dual-plane breast augmentation and transaxillary dual-plane breast augmentation combined with autologous fat transplantation was used for patients in observation group.Patients' basic information,surgery-related indicators,recovery situations,complications and patients' satisfactory data were collected.34 patients in control group and 38 patients in observation group were followed up.Results For surgery-related indicators and recovery situations,statistically significant difference was not found in the blood lost,duration of drainage tube and postoperative stay (P＞0.05),but was found in operation time (P＜0.05).And there was no significant difference in terms of surgical effects between two groups (P＞0.05).There were no complications such as hematoma,infection,capsular contracture in two groups.25 patients in observation group were performed B ultrasonic examination 6 months after operation.Multiple cysts were found at the cleavage in only 1 patient and were cured by suction.And the rest B ultrasonic results were negative for pathologic findings such as calcifications,cysts and masses.Conclusions Autologous fat transplantation is useful in minimizing the unaesthetic appearance of the cleavage and the bad feeling of the inframammary fold and thus a proper solution for the patient's breasts with thin soft tissue.
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Introducción: El instrumento Breast-Q® se ha ocupado para medir la calidad de vida de las pacientes sometidas a cirugía de aumento mamario. Se desconocen los factores que determinan la mejoría en la calidad de vida de estas pacientes. El objetivo de este trabajo es identificar los factores determinantes de la mejoría de la calidad de vida en pacientes sometidas a aumento mamario. Materiales y métodos: Se estudió una cohorte prospectiva de 52 pacientes sometidas a aumento mamario. Se estudiaron características sociodemográficas, mediciones antropométricas, variables relativas a la cirugía y se aplicó el instrumento Breast-Q®. Para el análisis estadístico se utilizó estadística descriptiva, el test de Wilcoxon para muestras pareadas y modelos de regresión lineal y logística. Resultados: Se encontró mejoría en la calidad de vida de forma global (p < 0,00001) y en todos los dominios salvo en el de «síntomas físicos¼. Dentro de los factores determinantes, existió una relación positiva entre el volumen de la prótesis y la mejoría en la calidad de vida de forma global (p = 0,032) y en los dominios «autoimagen y autoestima¼ (p = 0,01) y «vida sexual¼ (p = 0,001). Conclusión: La cirugía de aumento mamario incrementa significativamente la calidad de vida medido mediante el instrumento Breast-Q®. Los determinantes de la mejoría en la calidad de vida estarían directamente relacionados con el volumen de la prótesis.
Introduction: Breast-Q® instrument has been used for measuring the quality of life of patients undergoing breast augmentation surgery. The factors that determine the improvement in the quality of life of these patients are unknown. The aim of this work is to identify the determinant factors of improvement in the quality of life in patients undergoing breast augmentation. Materials and methods: A prospective cohort of 52 patients undergoing breast augmentation was studied. Sociodemographic features, anthropometric measurements, variables related to surgery were studied and the Breast-Q® instrument was applied. For statistical analysis it was used descriptive statistics and linear and logistic regression models. Results: We found improvement in the quality of life, globally (P < .00001) and in all domains except "physical symptoms’ domain. Among the determining factors, there was a positive correlation between the prosthesis volume and improvement in quality of life globally (P = .032) and in the domains "self-image and self-esteem" (P = .01) and "sexual life" (P = .001). Conclusion: Breast augmentation surgery significantly increases the quality of life measured by the Breast-Q® instrument. The determinant factors of improvement in quality of life, would be directly related to the implants volume.
Subject(s)
Humans , Female , Adolescent , Adult , Middle Aged , Young Adult , Breast/surgery , Mammaplasty/methods , Mammaplasty/psychology , Quality of Life , Body Mass Index , Cohort Studies , Socioeconomic Factors , Surveys and QuestionnairesABSTRACT
Introdução: Após o diagnóstico e tratamento do câncer de mama, algumas mulheres passam por alterações físicas, sociais e emocionais que repercutem muitas vezes na qualidade de vida e na autoestima. O objetivo é avaliar a qualidade de vida e autoestima de pacientes mastectomizadas submetidas ou não à reconstrução mamária após um mês de cirurgia. Métodos: A casuística foi composta por 89 pacientes, com idade igual ou superior a 30 anos, submetidas ou não à reconstrução mamária, e oriundas dos ambulatórios de Cirurgia Plástica e Mastologia do Hospital São Paulo e do Hospital Pérola Byington. O grupo 1 (n = 30) composto pelas pacientes mastectomizadas sem reconstrução mamária; o grupo 2 (n = 29) mastectomizadas com reconstrução mamária; e o grupo 3 (n = 30) pacientes sem alterações nas mamas. Para a avaliação da qualidade de vida, foram aplicados os instrumentos validados para uso no Brasil EORTC QLQ-C30 e Escala de Autoestima de Rosenberg UNIFESP/EPM. Resultados: Não foram observadas repercussões na qualidade de vida e autoestima das pacientes submetidas à mastectomia com ou sem a reconstrução mamária após um mês de cirurgia. Conclusão: Mulheres mastectomizadas com ou sem reconstrução mamária após um mês da cirurgia não apresentaram repercussões na qualidade de vida e na autoestima, quando comparadas entre si, bem como comparadas às mulheres sem história de câncer. É necessário que este tipo de avaliação, por meio dos questionários EORTC QLQ-C30 e QLQ-BR23, seja realizado no momento do diagnóstico do câncer de mama até o momento da pós-reconstrução mamária, com a finalidade de identificar em que fase se instalam as repercussões na qualidade de vida e autoestima.
Introduction: After diagnosis and treatment of breast cancer, some women go through physical, social, and emotional changes that often have an impact on their quality of life and self-esteem. This study aimed to assess the quality of life and self-esteem of mastectomized patients with or without breast reconstruction a month after surgery. Methods: The study consisted of 89 patients aged ≥ 30 years with or without breast reconstruction. They were recruited from the Plastic Surgery and Mastology clinic of São Paulo Hospital and Pérola Byington Hospital. Group 1 (n = 30) consisted of mastectomized patients without breast reconstruction; group 2 (n = 29) consisted of mastectomized patients with breast reconstruction; and group 3 (n = 30) consisted of patients without changes in the breasts. The EORTC QLQ-C30 and Rosenberg Self-Esteem Scale UNIFESP/EPM instruments, which are validated in Brazil, were used to assess their quality of life. Results: There were no observed effects in the quality of life and self-esteem of the patients who underwent mastectomy with or without breast reconstruction a month after surgery. Conclusion: The women with mastectomy with or without breast reconstruction a month after surgery showed no changes in their quality of life and self-esteem when compared among themselves and to women with no cancer history. It is necessary that this assessment, employing the EORTC QLQ-C30 and QLQ-BR23 questionnaires, be performed from the time of breast cancer diagnosis until after breast reconstruction to identify the stage when the quality of life and self-esteem are affected.
Subject(s)
Humans , Female , Middle Aged , Aged , History, 21st Century , Quality of Life , Self Concept , Breast , Breast Neoplasms , Cross-Sectional Studies , Patient Satisfaction , Mammaplasty , Plastic Surgery Procedures , Evaluation Study , Observational Studies as Topic , Mastectomy , Quality of Life/psychology , Breast/surgery , Breast Neoplasms/surgery , Breast Neoplasms/therapy , Cross-Sectional Studies/methods , Patient Satisfaction/statistics & numerical data , Mammaplasty/methods , Plastic Surgery Procedures/methods , Mastectomy/methods , Mastectomy/psychology , Mastectomy/statistics & numerical dataABSTRACT
Objective@#To evaluate the safety, reliability and effectiveness of "free style endoscopic technique" assisted transaxillary high level dual plane breast augmentation; To explore endoscopic techniques that can achieve higher efficiency and better result ; To discover a safe and effective method for dual plane dissection with the help of endoscopy.@*Methods@#Using new endoscopic techniques to perform transaxillary dual plane breast augmentation: ① High level dual plane technique, the muscle division line is about 1.5 cm higher than the original inferior mammary fold, the cephalic side of the muscle is retracted to the lower border of the areola with a special retractor to form a high level dual plane cavity, thus the upper and lower portion of the implant would be covered by pectorilis major muscle, while the rest of the implant was partially under breast parenchyma. ② "Free style endoscopic techniques" , the endoscopy and retractor are not fixed to each other, thus the space is exposed by an assistant with a new designed special retractor, while the operator is concentrate on dissecting with endoscopy in one hand and long tipped bowie in the other hand. ③ Accurate navigate technique, define the dissection border by acupuncture via skin in a 90 degree angle, thus to make the dissection right as preoperative design.@*Results@#There were 1 106 cases underwent this kind of surgery, while 405 of them, whose minimum follow up were 12 months were included in this retrospective study. The follow up period ranged from 12-60 months, the average follow up period is 24.3 months. The average operation time is (1.47 ±0.46) h, the average drainage removal time is (4.23±0.51) d after surgery. The perioperative complication rate is 0.99%, including an incision site change caused by intraoperative bleeding, 1 case of pneumothorax, 2 cases of bleeding after surgery. Long period complication including: 6 cases (1.48%) Ⅲ grade capsular contracture, 21 cases (5.20%) of nipple-areola sensation disorders, implant palpable occurred in 14 case (3.46%), 3 cases (0.74%) implant malposition, 2 cases (0.49%) implant distortion, the total reoperation rate is 2.47%. There was no infection, hematoma, seroma, curtain deformity, double bubble deformity occurred in our study.@*Conclusions@#The high level dual plane techniques not only can solve the deficient soft tissue coverage problem thus to lower the rate of implant palpability, but also can relieve the relationship of the pectorilis major muscle and the inframammary fold(IMF), offering an option to replace Ⅱ and Ⅲ type of dual plane techniques, decrease the risk of curtain deformity and double bubble deformity. The free style endoscopic techniques are very flexible and efficient, with the help of accurate navigate technique, it can archive an accurate cavity dissection, accurate and definite IMF, and a lower complication rate. Though the learning curve is relatively longer, it is really a safe and effective breast augmentation method worthwhile to learn and spread.