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• W2087286411 abstract "Sir: Since its development around the 1960s, the silicone prosthesis has become the implant of choice for augmentation mammaplasty. Implant reconstruction is the simplest form of breast reconstruction. However, some problems require solutions, such as extent and location of the incisions, intraoperative assessment of the ideal breast size, inhibition of capsular contracture, facility in the handling of the technique, and safety with regard to implant perforation. We propose a new breast reconstruction with miniprostheses, which are a series of 10-ml silicone gel prostheses. The operative technique and implant composition are similar to those for conventional silicone gel implants, except with regard to prosthesis volume. The original or periareolar incision is used. The space beneath the pectoral muscle is utilized. If the pectoral muscle is absent, the latissimus dorsi muscle with pedicle is transferred. The miniprostheses are inserted one by one beneath the pectoral muscle or latissimus dorsi muscle until the desired volume is achieved and defined very objectively during the operation. The incision is closed and a drainage tube is placed beneath the muscle. The tube is removed 3 days after operation and breast massage is started. We have performed this procedure in four patients ranging in age from 23 to 42 years. Two had defects after gland fibroadenoma excision, one had a defect after hemangioma excision, and one had a defect after reduction mammaplasty. The results were satisfactory. Our method has more advantages than the conventional method. Our rationale can be summarized as follows: The breast has a sufficiently natural feel and appearance. The individual miniprosthesis cannot be felt. The surface of the unit is slightly irregular in the transition from one miniprosthesis to another theoretically, but it cannot be felt on palpation in practice, because the miniprostheses are placed beneath the pectoral major muscle and a single capsule surrounds all the miniprostheses, as with conventional prostheses. The miniprostheses are enveloped by single capsule, with no septum forming between them, so the unit behaves as a single prosthesis. This method allows for smaller incisions. A smaller incision is used to introduce the 10-ml miniprosthesis than that used with conventional prostheses. The incisions do not exceed 2 cm. The submuscular space is always used. Breast volume and asymmetries are easily corrected during the operation. It is unnecessary to keep different sizes of miniprostheses, and only a certain number of miniprostheses need be kept. A number of them may be used, thereby substituting for a conventional prosthesis of any volume. It is easy to evaluate and achieve the ideal breast volume during the operation, because the miniprostheses are inserted one by one until the desired volume is achieved and defined very objectively intraopertively. This method is safer with regard to perforation. Because each miniprosthesis is only 10 ml, one perforation is safer than that in a conventional, 200-ml or larger prosthesis. There is a low rate of capsular contracture, perhaps because of the great ability of the miniprostheses to adjust to one another, sliding of the minprostheses among themselves, the greater capsular surface area, and the irregular capsular surface. The procedure can be widely used for mammaplasty. It can be utilized to correct amastia, breast atrophy, hypomastia with or without asymmetry, and especially partial breast reconstruction. Weiqi Yang, M.D. Department of Plastic and Burns Surgery The Second People’s Hospital Shenzhen, Guangdong, China Peiying Yang, M.D. Jie Luan, M.D. Jincai Fan, M.D. The Plastic Surgery Hospital Chinese Academy of Medical Sciences Beijing, China Zhixiang Zhu, M.D. Department of Plastic and Burns Surgery The Second People’s Hospital Shenzhen, Guangdong, China" @default.
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• W2087286411 date "2008-05-01" @default.
• W2087286411 modified "2023-09-27" @default.
• W2087286411 title "Breast Reconstruction with Miniprostheses" @default.
• W2087286411 doi "https://doi.org/10.1097/prs.0b013e31816b1276" @default.
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