Breast implants malposition prevention after aesthetic augmentation mammoplasty
DOI:
https://doi.org/10.15587/2519-4798.2023.293393Keywords:
breast implants malposition, prevention, women's physique, implant volumeAbstract
Prevention of breast implant malposition (BIM) after submuscular augmentation mammoplasty (SAMP) for hypomastia is an actual problem, as 4.7–5.2 % of women after primary SAMP and approximately 10 % after repeated SAMP require revision surgery due to this complication.
The aim. To determine the effectiveness of prevention of BIM after SAMP by choosing the implant volume depending on the physique of women.
Materials and methods. In 112 women, the choice of implant volume for SAMP was carried out in accordance with the High Five approach – the comparison group (Group C), in 46 women according to the developed algorithm – the main group (Group M). The algorithm took into account the risk of BIM in women of different physique depending on the implant volume. If a woman insisted on having a larger implant than was calculated, an additional internal bra was created.
One year after SAMP, the amount of BIM was assessed according to the developed methodology, according to which BIM was characterised by the percentage increase in the area of the neo-osseous in relation to the area of the prosthesis. The following categories of BIM were distinguished: absent (insignificant) 1.5 % to 6.4 %, mild – 6.5 % to 10.4 %, moderate – 10.5 % to 20.0 %, significant – more than 20 %. Women's body type was assessed by the Pignet’s Index, which distinguished three categories: strong <16, medium 16–25, and weak 26–35. In group M, the maximum possible implant volume with a low risk of BIM was considered to be for women with a weak physique – 360 ml, medium – 430 ml, strong – 650 ml.
Results The mean percentage of BIM was significantly lower in group M (7.2±1.8 %) compared to group C (9.1±6.1 %), p=0.036. At the same time, the incidence of significant BIM significantly decreased from 18 (16.1 %) in group C to 2 (4.3 %) in group M, p=0.044. Moreover, patients in group M had BIM that could be classified as moderate, while in group P, 9 (50 %) women had moderate and 9 significant BIM. In the case of additional creation of an internal bra, there was no significant BIM in any case, the average value of this indicator was 6.3±1.6 % (no or mild BIM).
Conclusion. The developed personalised approach to the choice of implant volume, taking into account the physique of women, significantly improves the results of SAMP and prevents significant BIM
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