| BackgroundBreast implant is a key factor in determining the morphological effect of breast augmentation surgery.Understanding the changes in breast morphology during the perioperative and early postoperative periods plays a crucial role in selecting implants,preoperative design,and predicting postoperative outcomes.In recent years,the smooth round implants have been increasingly favored by doctors and patients.At the same time,it has also been found in clinical practice that there is a higher risk of postoperative implant displacement and lower pole enlargement.Surgeons still have different understandings of the characteristics and changes in breast morphology after smooth round implant breast augmentation.and their internal causes and influencing factors are not clear.There is also a lack of objective research data,leading to significant confusion in implant selection,surgical indication screening,preoperative design.and other aspects.This study focuses on the clinical issues mentioned above,using three-dimensional scanning technology to analyze the breast shape characteristics,change trends.and stability time after smooth round implants breast augmentation,and further analyze the influencing factors of their morphology characteristics and changes.In addition,the breast morphology after augmentation with round and anatomic implants was compared.This study aims to provide a basis for the selection of implants,preoperative design,and determination of postoperative follow-up time points.The research content is as follows:Part 1 A prospective study of the dynamic change of breast three-dimensional morphology in the early stage after smooth round implant breast augmentationObjectiveClarify the trend and stability time of early breast morphology changes after smooth round implant breast augmentation.MethodsThree dimensional scans were obtained preoperatively,at 1st month,3rd month,6th month,and 12th month postoperatively from patients who underwent round implant breast augmentation.The breast morphology parameters were measured at various time points and the breast skin stretchability were calculated for each follow-up time point preoperatively and postoperatively,respectively.Differences in morphometric parameter measurements at different follow-up time points were contrasted using one-way repeated measures ANOVA.ResultsBreast basal width measurements were not significantly different at different followup time points postoperatively.There was a progressive downward shift in the position of the inframammary fold and a progressive increase in the interval of the medial border distance.The nipple-medial breast border,nipple-inframammary fold distance increased gradually.Breast projection and upper pole projection gradually decreased and the projection of the lower pole gradually increased.The position of the nipple gradually shifted outwards and superiorly.The breast volume gradually decreased.The breas volume of the upper pole gradually decreased,while the volume of the lower pole gradually increased;The proportion of upper pole volume gradually decreased,while the proportion of lower pole volume gradually increased.The breast skin stretchability gradually decreased.There was no statistically significant difference in all measurements between the 6th and 12th postoperative months.ConclusionsWithin 12 months after the smooth round implant breast augmentation,the breast basal width remained basically stable,and the overall breast shifted outward and downward,while the nipple shifted outward and upward.The volume gradually decreased,and the volume distribution shifted downward.All measurement values tended to stabilize at the 6th month after the surgery,so the 6th month can be a reliable time point for early postoperative effect evaluation.Part 2 Early changes in breast three-dimensional morphology and its influencing factors after smooth round implant augmentationObjectiveTo identify the influence factors of breast morphology changes after smooth round implant augmentation.MethodsPatients who underwent smooth round implant augmentation were selected.Stretchability of breast skin and soft-tissue pinch thickness before surgery were measured in the enrolled patients.Three dimensional scans of the enrolled patients were obtained preoperatively,as well as on the first and sixth postoperative months,and breast morphometric parameters were measured at each time point.The changes in various parameters from the 1 st to 6th month after surgery were calculated.Spearman rank correlation tests were performed between these data and implant parameters,subcutaneous tissue thickness,skin stretchability,age,and BMI to screen for highly correlated factors.Multiple linear regression analysis was performed.ResultsFrom the first month to the sixth month after operation,the position of the inframammary fold decreased by an average of 0.4± 0.3 cm.The degree of downward movement was highly positively correlated with the volume of the implant.The average displacement of the medial breast border was 0.2 ± 0.1 cm,which was highly positively correlated with the implant volume.The length of the nipple-medial breast border increased by 0.5± 0.3 cm,which was highly positively correlated with the stretchability of medial pole.The length of nipple-inframammary fold increased by 0.6 ± 0.3 cm.which was highly positively correlated with the implant volume and the skin stretchability of lower pole.The breast projection decreased by 0.4 ± 0.2 cm.which was highly positively correlated with preoperative breast projection.The nipple moved outward by 0.3± 0.2 cm,which was highly positively correlated with the stretchability of medial pole;the nipple moved up 0.2± 0.2 cm,which was highly positively correlated with the volume of the implant and the skin stretchability of lower pole.The average reduction in breast volume was 25.6±15.7 cc,and the reduction value was highly positively correlated with preoperative breast volume.ConclusionsIn the early stage after smooth round implant augmentation:1.The position of breast shifted outward and downward,the larger the implant volume,the more obvious the trend.2.The nipple shifted outward and upward,accompanied by an increase in N-MBB.The higher the preoperative SMP.the more lateral displacement of the nipple,the larger the implant volume and preoperative SLP,and the more upward displacement of the nipple.3.The length of N-IMF increased,the larger the implant volume,the higher the preoperative SLP,and the more significant the increase in N-IMF length,that is,the more prominent the protrusion of the lower pole.4.The breast projection was gradually reduced,and the higher the preoperative breast projection.the greater the postoperative reduction.5.The breast volume was reduced by 8.5%,and the larger the preoperative breast volume,the greater the postoperative volume reduction.Part 3 Characteristic and influencing factors of three-dimensional morphology of breast pre-and post-smooth round implant augmentationObjectiveIdentify the characteristics and influencing factors of breast morphology in the early stage after smooth round implant augmentation.MethodsPatients who underwent smooth round implant augmentation were selected.Three dimensional scans and measurements of enrolled patients were obtained preoperatively and at the sixth month postoperatively.The morphometric parameters as well as breast morphometric parameter change values at the sixth postoperative month were measured and calculated,and the correlation with the implant parameters,SLP,SMP,and subcutaneous tissue thickness was tested by Spearman rank correlation,and the factors with a high degree of correlation were selected and subjected to multiple linear regression analysis.ResultsThe N-IMF was 8.1 ± 0.8 cm at the sixth month postoperatively,which was an average increase of 0.3± 0.2 cm from the preoperative design value,and this value was highly correlated with the implant volume and SLP.The breast projection was 4.7 ± 0.6 cm,which was 0.6 cm lower than the expected breast projection,and the loss of projection was highly positively correlated with the preoperative breast projection.Nipple position was shifted outward by 0.8 ± 0.4 cm,which was highly positively correlated with implant projection and moderately positively correlated with SMP;The upward shift was 0.9± 0.4 cm,which was highly positively correlated with the implant projection.The breast volume was 285.4±21.3 cc.which was 52.2 ± 10.8 CC smaller than the expected volume,and the postoperative volume loss was highly positively correlated with the preoperative breast volume.ConclusionsThe breast morphology after smooth round implant augmentation shows the following characteristics:1.The N-IMF increased by about 4%compared to the preoperative design value,and the larger the implant volume and preoperative SLP,the more significant the degree of skin expansion of the breast lower pole.2.The actual projection of the breast was approximately 11.3%lower than expected,and the greater the preoperative breast projection,the more the postoperative breast projection was lost.3.The nipple shifted outward and upward,and the higher the projection of the implant,the more significant the nipple shifted outward and upward.4.The breast volume lost 15.2%compared to the expected value,and the larger the preoperative breast volume,the greater the postoperative volume loss.Part 4 Comparative study on three-dimensional breast morphology after augmentation with smooth round and anatomic implantsObjectiveClarify the differences in breast morphology between smooth round implants and anatomic implants after augmentation.MethodsThe patients who received breast augmentation with implants were divided into round group and anatomic group according to the shape of the selected implant.Three dimensional scans and measurements were performed on the enrolled patients before surgery,at the first and sixth months after surgery,to calculate the preoperative and postoperative BH/BW ratio,BHUP/BHLP ratio,BPUP/BPLP ratio,BVUP/BVLP ratio,and BP/BH ratio.The descending distance of submammary fold and the change of NIMF skin surface length were measured from 1 to 6 months after surgery.The breast projection loss rate and volume loss rate were calculated respectively in the two groups.Independent sample t test was used to compare parameters between the two groups.ResultsThere was no statistical difference in the ratio of preoperative shape parameters,the ratio of postoperative shape parameters and the breast volume loss rate between the round implant group and the anatomic implant group.The breast projection loss rate in the round implant group(13.0 ± 3.0%)was significantly lower than that in the anatomic group(20.3 ± 4.0%)(P=0.000).From the first to the sixth month after surgery,IMF descending distance of the round implant group(0.3± 0.2 cm)was greater than that of the anatomic implant group(0.2 ± 0.2 cm)(P=0.026).There was no significant difference in the N-IMF extension distance between the round implants(0.6± 0.3cm)and the anatomic implants(0.5 ± 0.2cm)(P=0.127).Conclusions1.Under strict control of surgical indications,there is no significant difference in breast morphological characteristics after augmentation using round or anatomical implants.2.The breast projection loss rate after augmentation with round implants is lower than that of anatomical implants,and the volume loss rate is similar to that of anatomical implants.3.Compared with anatomic implant,smooth round implant is more likely to lead to the downward movement of the inframammary fold in the early stage after breast augmentation. |
PDF Full Text Request