A Modification in Transabdominal Approach for Breast Augmentation (TABA) in Combined Surgery Patients

Güçer T
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Abstract

In combined surgery candidates, the transabdominal way to locate breast implants are preferred and applied with the abdominoplasty, aspiration lipoplasty and breast augmentation together in indicated cases. In 46 cases, very rare complication rate is observed as 3 cases with seroma in upper epigastric area and no infection or tissue circulation or nervous (sensorial) problems are observed. The technique contains a lower plane abdominoplasty incision, the wet technique saline infiltration to the abdominal area, aspiration lipoplasty following excess skin of the belly and undermining the central line, reaching medial breast regions, and fish hook shaped dissections from the medial supra fascial pectoral areas for the estimated volume of the breast implants differently from the previously described technique. Following the application of the implants, the skin between the breasts over the sternum, reattached to the base of the prepared hole with a fixation suture to facilitate the tunnel obliteration, and plication of rectus fascia and closing the incision of abdominoplasty completes the operation. A drainage provided by flat (7 or 10 mm Jackson-Pratt) drains applied for 48 hours following surgery. External combined garment for abdominoplasty and breast augmentation is applied for six weeks. By this vertical midline single tunneling technique, the previously described TABA surgery can be performed in a shorter operation time and lesser deformity and complication rate. EBM is accepted as Level V, Opinions of respected authorities, based on clinical experience, descriptive studies, or reports of expert committees.
联合手术患者经腹隆胸入路的改进
在联合手术候选人中,首选经腹方式定位乳房植入物,并在指征病例中与腹部成形术、吸脂术和隆胸术一起应用。46例患者中,3例出现上腹部血肿,并发症发生率极低,无感染、组织循环、神经(感觉)问题。该技术包括下平面腹部成形术切口,湿法生理盐水浸润腹部区域,腹部多余皮肤后吸脂成形术,破坏中线,到达乳房内侧区域,以及从内侧胸筋膜上区域进行鱼钩状剥离,以估计乳房植入物的体积,与先前描述的技术不同。植入物应用后,将胸骨上方乳房间的皮肤用固定缝线重新附着在准备好的孔的底部,方便隧道封闭,应用直肌筋膜并关闭腹部成形术切口即可完成手术。术后48小时采用扁平(7或10毫米杰克逊-普拉特)引流管引流。腹部成形术和隆胸术的外部复合衣应用6周。通过这种垂直中线单隧道技术,前文所述的TABA手术可以在更短的手术时间内完成,畸形和并发症发生率更低。EBM被接受为V级,即权威人士的意见,基于临床经验、描述性研究或专家委员会的报告。
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