背景:乳房植入物移除和囊切除术的数量继续迅速增加。外植体手术的目的应该是从美学和功能的角度优化患者的结果。
目的:确认无引流全囊切除术的安全性,并确定肌肉修复在去除胸肌下或双平面美容乳房植入物后的外植体结局中的作用。
方法:我们在2021年1月至2023年11月之间对我们的技术进行了回顾性评估。我们报告了一个单外科医生系列,包括140例从双平面或胸膜下口袋中取出美容乳房植入物的连续病例,全部进行全囊切除术。在每种情况下,囊切除术后对胸大肌进行了细致的修复。在任何情况下都不使用排水沟。所有患者均随访至少3个月。术后至少6个月评估患者满意度。
结果:通过执行所描述的无排水技术,没有血清肿的病例,血肿,气胸或美容乳房变形在这个系列。83%的患者被视为日间病例,患者对结果的满意度很高。
结论:不使用引流管的全囊切除术是一种新颖而安全的方法,精心修复胸大肌。血清肿的风险没有增加。肌肉修复可能有助于防止乳房外植体后美容畸形。
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: The number of breast implant removal and capsulectomy procedures continues to increase rapidly. The aim of
explant surgery should be to optimise patient outcomes from both an aesthetic and functional perspective.
OBJECTIVE: To confirm the safety of drainless total capsulectomy and to determine the role of muscle repair in
explant outcomes following the removal of sub-pectoral or dual-plane cosmetic breast implants.
METHODS: We conducted a retrospective evaluation of our technique between January 2021 and November 2023. We report a single surgeon series of 140 consecutive cases of cosmetic breast implant removal from dual-plane or sub-pectoral pockets, all performed with total capsulectomy. In each case, meticulous repair of the Pectoralis major muscle was performed following capsulectomy. Drains were not used in any case. All patients were followed up for a minimum of 3 months. Patient satisfaction was assessed a minimum of 6 months post-operatively.
RESULTS: By performing the described drainless technique, there were no cases of seroma, haematoma, pneumothorax or cosmetic breast distortion in this series. 83% of patients were treated as day cases and patient satisfaction with outcomes was high.
CONCLUSIONS: Total capsulectomy without the use of drains is a novel and safe approach, aided by careful repair of the Pectoralis major muscle. There is no increased risk of seroma. The muscle repair may help to prevent post-
explant cosmetic deformity of the breast.
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 .