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Endoscopic transaxillary prepectoral conversion for submuscular breast implants

  • Park, Si-Hyun (Department of Plastic and Reconstructive Surgery, Soonchunhyang University Hospital) ;
  • Sim, Hyung-Bo (Department of Plastic and Reconstructive Surgery, Soonchunhyang University Hospital)
  • 투고 : 2017.07.02
  • 심사 : 2017.10.03
  • 발행 : 2018.03.15

초록

Background During breast augmentation, the transaxillary approach provides the advantage of allowing the mammary prosthesis to be placed through incisions that are remote from the breast itself, thereby reducing the visibility of postoperative scars. For patients experiencing capsular contracture who do not want additional scars, the previous transaxillary scar can be used for site change and implant exchange. Methods This study analyzed 17 patients (34 breasts) with submuscular breast implants with grade III-IV capsular contracture who received treatment from 2010 to 2015. The mean age of the patients was 29 years (range, 20-38 years). The inclusion criterion was a pinch test of more than 3 cm at the upper pole of the breast. Previous axillary scars were used to expose the pectoralis fascia, and submuscular breast implants were removed carefully. The dissection underneath the pectoralis fascia was performed with endoscopic assistance, using electrocautery under direct visualization. Results The mean follow-up period was 14 months (range, 6-24 months). The entire dissection plane was changed from the submuscular plane to the subfascial plane. Round textured gel implants were used, with a mean implant size of 220 mL (range, 160-300 mL). Two patients developed grade II capsular contracture. There were no cases of malposition or asymmetry. Three patients complained of minor implant palpability. None of the patients required additional surgery. Conclusions Endoscopic subfascial conversion may be an effective technique for treating capsular contracture and avoiding scarring of the breast in selected patients.

키워드

참고문헌

  1. Wan D, Rohrich RJ. Revisiting the management of capsular contracture in breast augmentation: a systematic review. Plast Reconstr Surg 2016;137:826-41. https://doi.org/10.1097/01.prs.0000480095.23356.ae
  2. Adams WP Jr, Mallucci P. Breast augmentation. Plast Reconstr Surg 2012;130:597e-611e. https://doi.org/10.1097/PRS.0b013e318262f607
  3. Berry MG, Cucchiara V, Davies DM. Breast augmentation. Part II. adverse capsular contracture. J Plast Reconstr Aesthet Surg 2010;63:2098-107. https://doi.org/10.1016/j.bjps.2010.04.011
  4. Maxwell GP, Gabriel A. Non-cross-linked porcine acellular dermal matrix in revision breast surgery: long-term outcomes and safety with neopectoral pockets. Aesthet Surg J 2014;34:551-9. https://doi.org/10.1177/1090820X14528207
  5. Collis N, Sharpe DT. Recurrence of subglandular breast implant capsular contracture: anterior versus total capsulectomy. Plast Reconstr Surg 2000;106:792-7. https://doi.org/10.1097/00006534-200009020-00006
  6. Costagliola M, Atiyeh BS, Rampillon F. An innovative procedure for the treatment of primary and recurrent capsular contracture (CC) following breast augmentation. Aesthet Surg J 2013;33:1008-17. https://doi.org/10.1177/1090820X13502035
  7. Spear SL, Carter ME, Ganz JC. The correction of capsular contracture by conversion to "dual-plane" positioning: technique and outcomes. Plast Reconstr Surg 2003;112:456-66. https://doi.org/10.1097/01.PRS.0000070987.15303.1A
  8. Rohrich RJ, Parker TH 3rd. Aesthetic management of the breast after explantation: evaluation and mastopexy options. Plast Reconstr Surg 2007;120:312-5. https://doi.org/10.1097/01.prs.0000264400.42376.e9
  9. Sugimoto T. Open capsulotomy for capsular contracture: a new procedure for the prevention of recurrence. Aesthetic Plast Surg 1982;6:225-30. https://doi.org/10.1007/BF01570652
  10. Moufarrege R, Beauregard G, Bosse JP, et al. Outcome of mammary capsulotomies. Ann Plast Surg 1987;19:62-4. https://doi.org/10.1097/00000637-198707000-00010
  11. Melmed EP. Treatment of breast contractures with open capsulotomy and replacement of gel prostheses with polyurethane-covered implants. Plast Reconstr Surg 1990;86:270-4. https://doi.org/10.1097/00006534-199008000-00011
  12. Embrey M, Adams EE, Cunningham B, et al. Factors associated with breast implant rupture: pilot of a retrospective analysis. Aesthetic Plast Surg 1999;23:207-12. https://doi.org/10.1007/s002669900269
  13. Handel N, Cordray T, Gutierrez J, et al. A long-term study of outcomes, complications, and patient satisfaction with breast implants. Plast Reconstr Surg 2006;117:757-67. https://doi.org/10.1097/01.prs.0000201457.00772.1d
  14. Schwartz MR. Evidence-based medicine: breast augmentation. Plast Reconstr Surg 2017;140:109e-119e. https://doi.org/10.1097/PRS.0000000000003478
  15. Tebbetts JB. Transaxillary subpectoral augmentation mammaplasty: long-term follow-up and refinements. Plast Reconstr Surg 1984;74:636-49. https://doi.org/10.1097/00006534-198411000-00008
  16. Ho LC. Endoscopic assisted transaxillary augmentation mammaplasty. Br J Plast Surg 1993;46:332-6. https://doi.org/10.1016/0007-1226(93)90015-4
  17. Price CI, Eaves FF 3rd, Nahai F, et al. Endoscopic transaxillary subpectoral breast augmentation. Plast Reconstr Surg 1994;94:612-9. https://doi.org/10.1097/00006534-199410000-00007
  18. Tebbetts JB. Dual plane breast augmentation: optimizing implant-soft-tissue relationships in a wide range of breast types. Plast Reconstr Surg 2001;107:1255-72. https://doi.org/10.1097/00006534-200104150-00027
  19. Salgarello M, Visconti G. Transaxillary totally subfascial breast augmentation with anatomical breast implants: review of 27 cases. Plast Reconstr Surg 2014;133:220e-222e. https://doi.org/10.1097/01.prs.0000437235.00306.f6
  20. Aygit AC, Basaran K, Mercan ES. Transaxillary totally subfascial breast augmentation with anatomical breast implants: review of 27 cases. Plast Reconstr Surg 2013;131:1149-56. https://doi.org/10.1097/PRS.0b013e3182865d68
  21. Munhoz AM, Gemperli R, Sampaio Goes JC. Transaxillary subfascial augmentation mammaplasty with anatomic formstable silicone implants. Clin Plast Surg 2015;42:565-84. https://doi.org/10.1016/j.cps.2015.06.016
  22. Graf RM, Bernardes A, Rippel R, et al. Subfascial breast implant: a new procedure. Plast Reconstr Surg 2003;111:904-8. https://doi.org/10.1097/01.PRS.0000041601.59651.15
  23. Giordano PA, Rouif M, Laurent B, et al. Endoscopic transaxillary breast augmentation: clinical evaluation of a series of 306 patients over a 9-year period. Aesthet Surg J 2007;27:47-54. https://doi.org/10.1016/j.asj.2006.12.012
  24. Sim HB. Transaxillary endoscopic breast augmentation. Arch Plast Surg 2014;41:458-65. https://doi.org/10.5999/aps.2014.41.5.458
  25. Sim HB, Sun SH. Transaxillary endoscopic breast augmentation with shaped gel implants. Aesthet Surg J 2015;35:952-61. https://doi.org/10.1093/asj/sjv104

피인용 문헌

  1. Correlation between the inframammary fold and sixth rib: Application to breast reconstruction vol.33, pp.2, 2018, https://doi.org/10.1002/ca.23407