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DOI: 10.1055/a-1348-1481
Einfluss der Brustdimension bei der einzeitigen Augmentationsmastopexie auf die Implantatauswahl – Erfahrungen aus 103 konsekutiven Brustaugmentationen mit nanotexturierten Silikonimplantaten
Impact of breast dimension in one-stage augmentation mastopexies on implant selection: review of 103 consecutive breast augmentations with nanotextured silicone implants![](https://www.thieme-connect.de/media/hamipla/202102/lookinside/thumbnails/10-1055-a-1348-1481-1.jpg)
Zusammenfassung
Hintergrund Laut aktueller Studienlage weist die einzeitige Augmentationsmastopexie (AM) geringe Komplikationen auf und ist mit einer niedrigeren Reoperationsrate verbunden, als wenn ein zweizeitiges Vorgehen erfolgt. Bei der AM kann sich die Brustdimension im Vergleich zu jenen Fällen ohne zusätzliche Straffungsindikation deutlich unterscheiden. Dabei blieben diese Unterschiede nur unzureichend untersucht. In der vorliegenden Studie sollen diese zunächst quantifiziert und im Anschluss die Auswirkung der Brustdimension auf die Implantatauswahl eruiert werden. Zudem soll der Einfluss der Mastopexie auf das Outcome von Augmentationen mit runden nanotexturierten Silikonimplantaten evaluiert werden.
Patienten und Methoden Über einen Zweijahreszeitraum wurden alle Patientinnen mit primären Brustaugmentationen mit nanotexturierten Implantaten in die Studie eingeschlossen. Soziodemografische Daten, präoperative Brustmaße, Spezifikationen der eingesetzten Implantate und Komplikationen der Augmentationsgruppe ohne Straffung wurden mit jenen der Gruppe mit AM verglichen. Die Zufriedenheit der Patientinnen und der Operateure wurde mittels Likert-Skalen dokumentiert.
Ergebnisse Insgesamt wurden 206 Brustaugmentationen bei n = 103 Patientinnen durchgeführt. Das mittlere Follow-up betrug 24,0 ± 4,3 Monate. Im Vergleich zur Augmentation ohne Straffungsindikation lagen bei der AM breitere Brustbasen und größere präoperative Körbchengrößen vor, p < 0,001. In der Folge wurden bei der AM Implantate mit breiteren Durchmessern und niedrigeren Volumina (p < 0,05) ausgewählt, welche mit geringeren Projektionen verbunden waren, p < 0,001. Die Gesamtrevisionsraten nach Augmentationen ohne (n = 51) und mit Straffung (n = 52) betrugen 5,9 % und 19,2 %, p < 0,05. Die AM erhöhte gewebebedingte Revisionen von 2,0 % auf 13,4 % (p < 0,05) ohne Einfluss auf implantatbedingte Revisionen (3,9 % vs. 5,8 %, p = 0,663). Die Gesamtinzidenz von Kapselkontrakturen lag bei 1,9 %. In beiden Gruppen zeigte sich eine annähernd gleichhohe Zufriedenheit.
Schlussfolgerung Im Vergleich zu Augmentationen ohne Straffung führen präoperativ breitere Brustbasen und größere Brustvolumina zur Auswahl von signifikant unterschiedlichen Implantatdimensionen bei der AM. Nanotexturierte Implantate sind verbunden mit niedrigen Komplikationsraten, wobei ein erhöhtes Risiko für gewebebedingte Revisionen nach AM verbleibt. Weitere Studien sind notwendig, um eventuelle Vor- und Nachteile gegenüber etablierten Implantaten zu evaluieren.
Abstract
Introduction According to current studies, one-stage augmentation mastopexy (AM) is associated with only minor complications and a lower reoperation rate compared with a staged procedure. In AM, breast dimension can differ notably compared with those cases without simultaneous mastopexy. However, these differences have only been insufficiently investigated. This study aims to quantify the differences and then evaluate the effect of breast dimension on implant selection. In addition, it evaluates the influence of mastopexy on the outcome of augmentation mammoplasties with round nanotextured silicone gel implants.
Patients and Methods Over a two-year period, all patients with primary augmentation mammoplasties using nanotextured implants were included in the study. Patients’ demographic data, breast measurements, specifications of the implants placed, and complications in the breast augmentation group without mastopexy were compared with those of the group with AM. The satisfaction of patients and surgeons was documented using Likert scales.
Results A total of 206 breast augmentations were performed in n = 103 patients. The mean follow-up was 24.0 ± 4.3 months. Compared with augmentations without an indication for simultaneous mastopexy, the AM group had wider breast bases and larger preoperative cup sizes; p < 0.001. As a result, implants selected for AM had greater diameters and lower volumes (p < 0.05) and were associated with smaller projections; p < 0.001. The total revision rates after augmentations without (n = 51) and with combined mastopexy (n = 52) were 5.9 % and 19.2 % (p < 0.05), respectively. AM increased tissue-related revisions from 2.0 % to 13.4 % (p < 0.05) without having an impact on implant-related revisions (3.9 % vs. 5.8 %, p = 0.663). The overall incidence of capsular contracture was 1.9 %. Satisfaction levels were approximately equal in both groups.
Conclusion In comparison to augmentations without mastopexy, wider breast bases and larger breast volumes before surgery lead to the selection of significantly different implant dimensions in AM. Nanotextured silicone implants are associated with low complication rates, while an increased risk for tissue-related revisions of the combined procedure remains. Further studies are necessary in order to evaluate possible advantages and disadvantages over established implants.
Schlüsselwörter
Brustaugmentation - Ästhetisch-Plastische Chirurgie - nanotexturierte Implantate - einzeitige Augmentationsmastopexie - subglanduläre Augmentation - partiell submuskuläre AugmentationKey words
Breast augmentation - nanotextured implants - subglandular augmentation - partial submuscular augmentation - one-stage augmentation mastopexyPublication History
Received: 28 August 2020
Accepted: 21 December 2020
Article published online:
15 April 2021
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