目的 探讨"短距、多段"埋没导引缝合法在矫正隆乳术后早期假体位置过低中的手术技巧和疗效。 方法 2019年8月至2022年1月，四川省人民医院整形外科收治因小乳症行腋窝入路假体隆乳而术后早期出现假体位置过低的女性患者15例，年龄23～35(27.3±3.6)岁；假体位置异常16～35 (23.8±5.8) d。12例患者表现为单侧假体位置过低，3例为双侧假体位置过低。采用"短距、多段"埋没导引缝合法予以矫正，即以2-0不可吸收缝线短距、多段缝合消除过低的假体腔隙下极。手术前后测量患者双侧乳头至胸骨中线距离、胸骨切迹至乳头距离、乳头至乳房下皱襞距离和锁骨中点至乳房下皱襞距离，并进行统计学分析，以评估"短距、多段"埋没导引缝合法对隆乳术后早期假体位置过低的疗效。 结果 15例患者术后伤口均一期愈合，无血肿、感染、瘢痕增生等并发症。均随访6～12(8.0±1.9)个月。14例患者对矫正后效果满意，1例患者进行2次矫正后得到满意结果。矫正后乳头至乳房下皱襞距离缩短0.8～1.4(1.2±0.2) cm,锁骨中点至乳房下皱襞距离缩短1.0～1.6(1.3±0.4) cm，差异均有统计学意义(t＝31.17、33.78，均P<0.05)。矫正后乳头至胸骨中线距离变化0.1～0.3(0.16±0.10) cm，胸骨切迹距离至乳头距离变化0～0.2(0.12±0.10) cm，差异均无统计学意义(均P>0.05)。 结论 采用"短距、多段"埋没导引缝合法矫正隆乳术后早期假体位置过低效果确切，具有操作简单、创伤小、无附加切口等优点，值得临床应用。 Objective To introduce a surgical technique of " short distances and multi-segment" buried-guiding suture method and its effects in the surgery of early descent of prosthesis after augmentation mammaplasty. Methods From August 2019 to January 2022, 15 cases of early descent of prosthesis after augmentation mammaplasty due to axillary approach breast augmentation for micromastia were admitted to the Plastic Surgery Department of Sichuan Provincial People′s Hospital, aged 23-35 years (27.3±3.6) and duration of dislocation from 16 to 35 days (23.8±5.8). There were 12 patients showed unilateral prosthesis drops and 3 patients showed bilateral prosthesis drops. " Short distances and multi-segment" buried-guiding suture method was used to solve the problem, i. e., 2-0 non-absorbable sutures were used to eliminate the lower pole of prosthetic cavity with " short distances and multi-segment" sutures. The distance from the nipple to the midline of the sternum, the distance from the sternotomy to the nipple, the distance from the nipple to the inframammary fold and the distance from the midclavicular point to the inframammary fold were measured bilaterally before and after surgery, and statistical analysis was performed to evaluate the efficacy of the " short distances and multi-segment" buried-guiding suture method for early descent of prosthesis after breast augmentation. Results All incisions healed by first intention without complications such as hematoma, infection, or scar hyperplasia. 15 patients were followed up for 6-12 months (8.0±1.9). 14 patients were satisfied with the results after surgery, and 1 patient received satisfactory results after secondary surgery. The distance from nipple to inframammary fold was shortened by 0.8-1.4 cm after surgery (1.2±0.2), and the distance from mid-clavicle to inframammary fold was shortened by 1.0-1.6 cm (1.3±0.4), and the differences were statistically significant as compared with the values before surgery (t=31.17, P<0.05 t=33.78, P<0.05). After surgery, the change in the distance from nipple to sternal was 0.1-0.3 cm (0.16±0.10), and the change in the distance from sternal notch to nipple was 0-0.2 cm (0.12±0.10), and the differences were not statistically significant (P>0.05). Conclusions With the advantages of simple operation, little trauma and no additional incision, the " short distance and multi-stage" buried-guiding suture method in the surgery of early descent of prosthesis after augmentation mammaplasty is worthy of clinical application.
Use of " short distances and multi-segment" buried guiding suture in the surgery of early descent of prosthesis after augmentation mammoplasty
Objective To introduce a surgical technique of " short distances and multi-segment" buried-guiding suture method and its effects in the surgery of early descent of prosthesis after augmentation mammaplasty. Methods From August 2019 to January 2022, 15 cases of early descent of prosthesis after augmentation mammaplasty due to axillary approach breast augmentation for micromastia were admitted to the Plastic Surgery Department of Sichuan Provincial People′s Hospital, aged 23-35 years (27.3±3.6) and duration of dislocation from 16 to 35 days (23.8±5.8). There were 12 patients showed unilateral prosthesis drops and 3 patients showed bilateral prosthesis drops. " Short distances and multi-segment" buried-guiding suture method was used to solve the problem, i. e., 2-0 non-absorbable sutures were used to eliminate the lower pole of prosthetic cavity with " short distances and multi-segment" sutures. The distance from the nipple to the midline of the sternum, the distance from the sternotomy to the nipple, the distance from the nipple to the inframammary fold and the distance from the midclavicular point to the inframammary fold were measured bilaterally before and after surgery, and statistical analysis was performed to evaluate the efficacy of the " short distances and multi-segment" buried-guiding suture method for early descent of prosthesis after breast augmentation. Results All incisions healed by first intention without complications such as hematoma, infection, or scar hyperplasia. 15 patients were followed up for 6-12 months (8.0±1.9). 14 patients were satisfied with the results after surgery, and 1 patient received satisfactory results after secondary surgery. The distance from nipple to inframammary fold was shortened by 0.8-1.4 cm after surgery (1.2±0.2), and the distance from mid-clavicle to inframammary fold was shortened by 1.0-1.6 cm (1.3±0.4), and the differences were statistically significant as compared with the values before surgery (t=31.17, P<0.05 t=33.78, P<0.05). After surgery, the change in the distance from nipple to sternal was 0.1-0.3 cm (0.16±0.10), and the change in the distance from sternal notch to nipple was 0-0.2 cm (0.12±0.10), and the differences were not statistically significant (P>0.05). Conclusions With the advantages of simple operation, little trauma and no additional incision, the " short distance and multi-stage" buried-guiding suture method in the surgery of early descent of prosthesis after augmentation mammaplasty is worthy of clinical application.
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