Mastoplasty

  • 文章类型: Journal Article
    背景:囊膜挛缩症(CC)仍然是非常常见的并发症,也是乳房植入手术后再次手术的主要原因。白三烯在与假体周围囊发育相关的炎症级联中起重要作用。本文的目的是评估由于这种病因而进行二次乳腺扩张的女性患者的包膜挛缩复发率。术后护理期间有或没有白三烯抑制剂治疗。
    方法:回顾性评估64例因CC而接受二次乳房增大术的女性。在这些病人中,20例(31%)用孟鲁司特治疗3个月。其余44人(69%)没有接受抗白三烯。术后一年后,使用Baker分类和磁共振成像测量包膜挛缩的存在。中位随访期为15个月。
    结果:接受孟鲁司特(n=20)的患者的CC率为15%(n=1)。未接受抗白三烯治疗的妇女(n=44)的CC率为16%(n=7)。
    结论:我们的研究结果表明,与未接受治疗的患者相比,术后3个月使用孟鲁司特治疗的包膜挛缩率较低。
    方法:本期刊要求作者为每篇文章分配一定程度的证据。对于这些循证医学评级的完整描述,请参阅目录或在线作者说明www。springer.com/00266.
    BACKGROUND: Capsular contracture (CC) remains a very common complication and the main cause of reoperation following a mammary implant surgery. Leukotrienes play an important role in the inflammatory cascade linked to the development of the periprosthetic capsule. The aim of this paper is to evaluate the incidence of recurrence of capsular contracture in female patients who underwent a secondary mammary augmentation due to this etiology, with and without treatment with leukotriene inhibitors during postoperative care.
    METHODS: Sixty-four women submitted to a secondary mammary augmentation due to CC were evaluated retrospectively. Out of these patients, 20 (31%) were treated with Montelukast for 3 months. The remaining 44 (69%) did not receive antileukotriene. The presence of capsular contracture was measured using the Baker classification and magnetic resonance imaging a year after postoperative care. The median follow-up period was 15 months.
    RESULTS: The patients receiving Montelukast (n = 20) presented a 15% CC rate (n = 1). The women that did not receive antileukotriene therapy (n = 44) presented a 16% CC rate (n = 7).
    CONCLUSIONS: The results of our study show that treatment with Montelukast for 3 months after the operation is associated with lower rates of capsular contracture when compared to patients that did not receive the treatment.
    METHODS: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
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  • 文章类型: Journal Article
    背景:胸壁轮廓手术是女性对男性(FtM)变性者性重新分配的第一步,有助于增强自我形象并促进新的性别角色生活。主要目标是通过去除女性轮廓来使胸部男性化。胸部轮廓,疤痕放置,疤痕形状,疤痕长度,乳头-乳晕位置,乳头大小和乳晕大小是关键点。
    方法:在2013年7月至2016年6月之间,25名FtM变性患者接受了外科手术以创建男性胸壁轮廓。在我们的研究中,我们只考虑了16例接受了双切口手术的患者。
    结果:患者调查显示,患者对美学结果的满意度很高。在我们组,无并发症发生,两名患者接受了腋下犬耳翻修和乳头重建的补充手术。
    结论:作者提出了FtM变性患者手术的新技术方法和适应症。强调胸肌的较长的疤痕,一个较小的乳头和一个调整大小和重新修饰的乳晕是我们的技术的关键点,以使男性外观的胸部。伤疤是永久性的,但他们中的大多数会褪色,病人对他们新的“男性”胸部外观充满热情。高水平的满意度,良好的美学效果和较低的并发症发生率建议我们在中、大型乳房中使用该技术。
    本期刊要求作者为每篇文章分配一定程度的证据。对于这些循证医学评级的完整描述,请参阅目录或在线作者说明www。springer.com/00266.
    BACKGROUND: Chest-wall contouring surgery is one of the first steps in sexual reassignment in female-to-male (FtM) transsexuals that contributes to strengthening of the self-image and facilitates living in the new gender role. The main goal is to masculinize the chest by removing the female contour. Chest contour, scar placement, scar shape, scar length, nipple-areola position, nipple size and the areola size are the key points.
    METHODS: Between July 2013 and June 2016, 25 FtM transgender patients underwent surgical procedures to create a masculine chest-wall contour. In our study, we just considered 16 patients who have undergone chest surgery with the double incision method.
    RESULTS: The patients\' survey revealed a high satisfaction rate with the aesthetic result. In our group, no complications occurred, and two patients have undergone supplementary surgery for axillary dog-ear revision and nipple reconstruction.
    CONCLUSIONS: The authors propose a new technical approach and indications for FtM transgender patients\' surgery. A longer scar that emphasizes the pectoralis muscle, a smaller nipple and a resized and refaced areola are the key points of our technique to give a masculine appearance to the chest. The scars are permanent, but most of them will fade and the patients are enthusiastic with their new \"male\" chest appearance. The high level of satisfaction, the great aesthetic result and the low rate of complications suggest to us the use of this technique in medium- and large-size breasts.
    UNASSIGNED: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
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