Our Experiences With Bi-Planar Mastopexy-Augmentation

R. Anlatıcı
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Abstract

Aims: By observing some restrictions with the widely performed mastopexy-augmentation operation solely involving the subglandular plane, we modified the method into a two-plane intervention in a number of selected cases. In this retrospective clinical study, we aimed to share our experiences with single stage bi-planar mas-topexy-augmentation. Methods: We performed a vertical mammoplasty and dissected both the subglandular plane, to fix the glandular tissue to a higher pectoral fascial level, and the submuscular plane to insert the implant. Additionally, we utilized either the superior-median dermofat or the dermoglandular flap to cover the implants completely or incom- pletely, aiming for a more stabilized vertical closure. The results were assessed retrospectively and statistically. Results: Thirty-six cases (72 breasts) were included in the study. The average age was 42 years and the average follow-up period was 13 months. The mean sizes of the implants were 211.81±67.48cc for the right breasts and 213.19±66.41cc for the left breasts. Twenty-eight cases (77.78%) were classified as primary and the remaining eight (22.22%) as secondary. Revision operations were demanded in five (13.89%) cases, three (10.71%) in the primary and two (25%) in the secondary group. Postoperative complications were observed in 50% of the study population and also 50% of each group. However, whereas all complications were identified as major in the secondary group, only three cases (10.71%) of major complications were reported in the primary group. There was a significant statistical relationship between the grade of ptosis and minor complications (for which the grade 3 ptosis group was responsible). Problems due to previous breast operations of the secondary group were significantly correlated with the major problems in our study population. However, the grade of ptosis, implant volume, and previous mastopexy-aug- mentation operation were not related with the revision operations and postoperative complications. it is feasible to per- form bi-planar mastopexy-augmentation to overcome the limitations of the widely performed one-plane method. However, potential postoperative complications should be taken into consideration and more caution in secondary cases is needed due to higher complication rates.
双平面乳房隆胸术的经验
目的:通过观察广泛进行的乳腺隆胸手术仅涉及腺下平面的一些限制,我们在一些选定的病例中将该方法修改为双平面干预。在这项回顾性临床研究中,我们的目的是分享我们在单阶段双平面乳房增厚术中的经验。方法:采用垂直乳房成形术,解剖腺下平面,将腺组织固定在胸筋膜较高水平,解剖肌下平面,置入假体。此外,我们利用真皮上正中瓣或真皮腺瓣完全或不完全覆盖种植体,以获得更稳定的垂直闭合。对结果进行回顾性和统计学评估。结果:36例(72个乳房)纳入研究。平均年龄42岁,平均随访时间13个月。右乳植入体平均大小为211.81±67.48cc,左乳植入体平均大小为213.19±66.41cc。原发性28例(77.78%),继发性8例(22.22%)。5例(13.89%)需行矫正手术,其中原发性3例(10.71%),继发性2例(25%)。术后并发症在50%的研究人群中观察到,每组也有50%。然而,继发组所有并发症均为主要并发症,而原发性组仅报告了3例(10.71%)主要并发症。上睑下垂分级与轻微并发症(3级上睑下垂组为主要原因)之间存在显著的统计学关系。第二组既往乳房手术引起的问题与我们研究人群的主要问题显著相关。而上睑下垂的程度、种植体的体积、以前的乳房修复手术与翻修手术和术后并发症无关。双平面乳房隆胸术克服了目前广泛应用的单平面乳房隆胸术的局限性,是可行的。然而,应考虑到潜在的术后并发症,由于并发症发生率较高,继发性病例需要更加谨慎。
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