背景:隆胸通常是通过将植入物插入乳房来进行的。然而,有时为了方便患者和外科医生使用可注射填充剂。如果有异物,如生物材料,被注射到体内,炎症等并发症,肉芽肿,和组织坏死可因异物反应而发生。
方法:一名39岁的女性患者因压痛来我院就诊,发红,双乳肿胀.在当前咨询之前4年,该患者使用植入物进行了双侧隆胸。
方法:关于磁共振成像(MRI),观察到囊性病变和积液,发现表明植入物破裂;因此,计划进行手术切除两个植入物.
方法:术中,植入物在上外侧部分错位而没有破裂。囊挛缩的发现也不明显。观察到大量的炎性肉芽肿,并在胸前平面切除,植入物立即插入新的胸下平面。
结果:新植入物的体积为175mL,比以前的小,根据患者的喜好。来自先前植入袋的液体的细胞学没有显示恶性肿瘤的证据,肉芽肿被确定为由活检异物反应引起的炎性组织。手术后双乳过度突出得到纠正,术后3个月内,患者对美学结果满意,无任何并发症。
结论:使用可注射填充剂进行隆胸有误诊的风险,and,因此,外科医生应始终谨慎行事。
BACKGROUND: Breast augmentation is usually performed by inserting implants into the breasts. However, injectable fillers are sometimes used for the convenience of both patients and surgeons. If foreign substances, such as biomaterials, are injected into the body, complications such as inflammation, granuloma, and tissue necrosis can occur owing to foreign body reactions.
METHODS: A 39-year-old female patient visited our hospital complaining of tenderness, redness, and swelling in both breasts. The patient had undergone bilateral breast augmentation using implants 4 years prior to current consult.
METHODS: On magnetic resonance imaging (MRI), cystic lesions and fluid collections were observed, with findings suggesting implant rupture; hence, surgery was planned to remove both implants.
METHODS: Intraoperatively, the implant was malpositioned in the upper lateral portion without rupture. Capsular contracture findings were also not prominent. A large amount of inflammatory granuloma was observed and removed in the prepectoral plane, and the implants were immediately inserted into a new subpectoral plane.
RESULTS: The volume of the new implant was 175 mL, which was smaller than the previous one, as per the patient preference. Cytology of the fluid from the previous implant pocket showed no evidence of malignancy, and the granuloma was identified as inflammatory tissue caused by a foreign body reaction on biopsy. The excessive protrusion of both breasts was corrected after surgery, and the patient was satisfied with the aesthetic outcomes without any complications up to 3 months after surgery.
CONCLUSIONS: The use of injectable fillers for breast augmentation carries the risk of misdiagnosis, and, therefore, surgeons should always exercise caution.