{"title":"腋窝隆胸后的疤痕感知和结果：患者和观察者报告的疤痕质量的前瞻性分析。","authors":"Alexandre Mendonça Munhoz","doi":"10.1093/asj/sjaf052","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>The transaxillary (TAA) approach offers breast augmentation (BA) with inconspicuous scarring. Previous investigations of scar outcomes have involved limited follow-up/samples, and no clinical studies have specifically assessed scars with scar-specific instruments.</p><p><strong>Objectives: </strong>The primary aim of this study was to evaluate axillary incision and associated complications with TAA BA.</p><p><strong>Methods: </strong>A cohort of patients who underwent TAA BA was identified. Scar outcome was evaluated with the Patient and Observer Scar Assessment Scale (POSAS) v. 2.0 at 1-, 6-, and 12-month study endpoints.</p><p><strong>Results: </strong>The cohort contained 71 patients (mean [standard deviation] age, 28.1 [6.1] years) and 142 axillary incisions, with average follow-up of 58.3 [28.6] months. Eleven patients (15.4%) experienced at least 1 complication, most frequently axillary banding (4.2%). The mean axillary incision length was 37.1 mm (range, 25-66 mm). Nonuse of implant sleeves (P < .001), the use of textured-surface implants (P < .001), and implant volume >350 cc (P < .001) were associated with larger incisions. At 12 months the poorest scores were related to color (mean, 2.35; range, 1-6), and 81% and 78.2% of patient and observer opinion scores were low/intermediate grade, respectively. Textured-surface implants (P < .001), implant volume >350 cc (P < .001), and nonuse of sleeve (P < .001) were significant risk factors for high/very-high POSAS overall scores at 1-year follow-up.</p><p><strong>Conclusions: </strong>Despite extensive research on BA procedures, studies on the TAA are limited and have not analyzed long-term incision-related outcomes. The data obtained in this study demonstrate that the TAA is a reliable technique, and POSAS evaluations showed that most patients presented satisfactory results and higher satisfaction with lower POSAS scores at 1 year postsurgery. Adequate preoperative planning and incision placement allows surgeons to perform this technique safely while minimizing risks of poor scar outcome.</p><p><strong>Level of evidence: 4 (therapeutic): </strong></p>","PeriodicalId":7728,"journal":{"name":"Aesthetic Surgery Journal","volume":" ","pages":"662-672"},"PeriodicalIF":3.0000,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Scar Perception and Outcomes After Transaxillary Breast Augmentation: A Prospective Analysis of Patient- and Observer-Reported Scar Quality.\",\"authors\":\"Alexandre Mendonça Munhoz\",\"doi\":\"10.1093/asj/sjaf052\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>The transaxillary (TAA) approach offers breast augmentation (BA) with inconspicuous scarring. Previous investigations of scar outcomes have involved limited follow-up/samples, and no clinical studies have specifically assessed scars with scar-specific instruments.</p><p><strong>Objectives: </strong>The primary aim of this study was to evaluate axillary incision and associated complications with TAA BA.</p><p><strong>Methods: </strong>A cohort of patients who underwent TAA BA was identified. Scar outcome was evaluated with the Patient and Observer Scar Assessment Scale (POSAS) v. 2.0 at 1-, 6-, and 12-month study endpoints.</p><p><strong>Results: </strong>The cohort contained 71 patients (mean [standard deviation] age, 28.1 [6.1] years) and 142 axillary incisions, with average follow-up of 58.3 [28.6] months. Eleven patients (15.4%) experienced at least 1 complication, most frequently axillary banding (4.2%). The mean axillary incision length was 37.1 mm (range, 25-66 mm). Nonuse of implant sleeves (P < .001), the use of textured-surface implants (P < .001), and implant volume >350 cc (P < .001) were associated with larger incisions. At 12 months the poorest scores were related to color (mean, 2.35; range, 1-6), and 81% and 78.2% of patient and observer opinion scores were low/intermediate grade, respectively. Textured-surface implants (P < .001), implant volume >350 cc (P < .001), and nonuse of sleeve (P < .001) were significant risk factors for high/very-high POSAS overall scores at 1-year follow-up.</p><p><strong>Conclusions: </strong>Despite extensive research on BA procedures, studies on the TAA are limited and have not analyzed long-term incision-related outcomes. The data obtained in this study demonstrate that the TAA is a reliable technique, and POSAS evaluations showed that most patients presented satisfactory results and higher satisfaction with lower POSAS scores at 1 year postsurgery. Adequate preoperative planning and incision placement allows surgeons to perform this technique safely while minimizing risks of poor scar outcome.</p><p><strong>Level of evidence: 4 (therapeutic): </strong></p>\",\"PeriodicalId\":7728,\"journal\":{\"name\":\"Aesthetic Surgery Journal\",\"volume\":\" \",\"pages\":\"662-672\"},\"PeriodicalIF\":3.0000,\"publicationDate\":\"2025-06-16\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Aesthetic Surgery Journal\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1093/asj/sjaf052\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"SURGERY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Aesthetic Surgery Journal","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1093/asj/sjaf052","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"SURGERY","Score":null,"Total":0}
Scar Perception and Outcomes After Transaxillary Breast Augmentation: A Prospective Analysis of Patient- and Observer-Reported Scar Quality.
Background: The transaxillary (TAA) approach offers breast augmentation (BA) with inconspicuous scarring. Previous investigations of scar outcomes have involved limited follow-up/samples, and no clinical studies have specifically assessed scars with scar-specific instruments.
Objectives: The primary aim of this study was to evaluate axillary incision and associated complications with TAA BA.
Methods: A cohort of patients who underwent TAA BA was identified. Scar outcome was evaluated with the Patient and Observer Scar Assessment Scale (POSAS) v. 2.0 at 1-, 6-, and 12-month study endpoints.
Results: The cohort contained 71 patients (mean [standard deviation] age, 28.1 [6.1] years) and 142 axillary incisions, with average follow-up of 58.3 [28.6] months. Eleven patients (15.4%) experienced at least 1 complication, most frequently axillary banding (4.2%). The mean axillary incision length was 37.1 mm (range, 25-66 mm). Nonuse of implant sleeves (P < .001), the use of textured-surface implants (P < .001), and implant volume >350 cc (P < .001) were associated with larger incisions. At 12 months the poorest scores were related to color (mean, 2.35; range, 1-6), and 81% and 78.2% of patient and observer opinion scores were low/intermediate grade, respectively. Textured-surface implants (P < .001), implant volume >350 cc (P < .001), and nonuse of sleeve (P < .001) were significant risk factors for high/very-high POSAS overall scores at 1-year follow-up.
Conclusions: Despite extensive research on BA procedures, studies on the TAA are limited and have not analyzed long-term incision-related outcomes. The data obtained in this study demonstrate that the TAA is a reliable technique, and POSAS evaluations showed that most patients presented satisfactory results and higher satisfaction with lower POSAS scores at 1 year postsurgery. Adequate preoperative planning and incision placement allows surgeons to perform this technique safely while minimizing risks of poor scar outcome.
期刊介绍：
Aesthetic Surgery Journal is a peer-reviewed international journal focusing on scientific developments and clinical techniques in aesthetic surgery. The official publication of The Aesthetic Society, ASJ is also the official English-language journal of many major international societies of plastic, aesthetic and reconstructive surgery representing South America, Central America, Europe, Asia, and the Middle East. It is also the official journal of the British Association of Aesthetic Plastic Surgeons, the Canadian Society for Aesthetic Plastic Surgery and The Rhinoplasty Society.
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