Our strategy in complication management of augmentation mammaplasty with polyacrylamide hydrogel injection in 235 patients
Our strategy in complication management of augmentation mammaplasty with polyacrylamide hydrogel injection in 235 patients
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DOI：
10.1016/j.bjps.2010.10.004
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发表时间：
2011-06-01
影响因子：
2.7
通讯作者：
Cheng, Ning-Xin
中科院分区：
文献类型：
--
作者：
Luo, Sheng-Kang;Chen, Gunang-Ping;Cheng, Ning-Xin
聚丙烯酰胺水凝胶（PAAG）曾在中国广泛用于隆胸。尽管2006年已禁止隆乳，但大量用凝胶注射隆乳的患者仍因其并发症而继续寻求医疗建议。这些并发症的临床处理从来没有标准化。我们总结了235例PAAG注射隆乳后并发症患者的数据，并分析了并发症的类型和原因。对228例有肿块、乳房疼痛或触痛、乳房不对称或畸形、功能或心理问题的患者进行MRI检查，以排除肿瘤、感染和描述疾病。所有患者均行乳晕切口手术排胶，108例即刻植入硅胶假体，28例延期6个月植入，大部分患者（214/235）对治疗满意，排胶后症状消失。凝胶分布和受累组织清晰，MRI排除了肿瘤。68例患者术后MRI显示无明显PAAG残留。在使用硅胶乳房植入体的即刻或延迟再造患者中，呈现良好的乳房轮廓。结论：乳房肿块、疼痛和畸形是PAAG注射隆乳术后的主要并发症。心理问题应引起重视。MRI是一种敏感、准确的诊断和疗效评价方法。手术取出注射的凝胶是并发症管理的首选方法。在严格选择的情况下，PAAG术后植入硅胶假体修复乳房外形是有效的。我们治疗PAAG相关并发症的策略被证明是有用的。(C)2010年英国整形、重建和美容外科医生协会。由爱思唯尔有限公司出版。保留所有权利。
Polyacrylamide hydrogel (PAAG) was once widely used in breast augmentation in China. Although it had been banned for augmentation mammaplasty in 2006, a large number of patients whose breasts were augmented with the gel injection have continued to seek medical advice because of its complications. The clinical management of these complications has never been standardised.The data of a total of 235 patients with complications following PAAG-injected breast augmentation have been summarised and the types and causations analysed. Magnetic resonance imaging (MRI) was undertaken in 228 patients with palpable masses, breast pain or tenderness, asymmetry or deformity and functional or psychological problems to eliminate neoplasm, infection and to delineate the diseases. The surgical gel evacuation via periareolar incisions was performed for all patients and immediate silicone breast prostheses were implanted in 108 patients and were delayed in 28 cases by 6 months.Most patients (214/235) of the group were satisfied with the treatment, and symptoms disappeared after removal of the gel. The gel distribution and involved tissue were well defined and neoplasm was ruled out by MRI. Postoperative MRI in 68 patients revealed that no obvious PAAG remaining. In either immediate or delayed reconstructive patients with silicone breast implants, good breast contour presented. A diagnosis and management strategy for these complications is proposed.In conclusion, the breast masses, pain and deformity are major complications after PAAG-injected breast augmentation. Psychological problems should be paid attention to. MRI is a sensitive and accurate method for diagnosis and treatment evaluation. Surgical removal of injected gel is the preferred method for complication management. The implantation of silicone prostheses for breast contour restoration after PAAG evacuation is effective for patients under strict selection. Our strategy for treating PAAG-related complications proved useful. (C) 2010 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.