The Clinical Study About The Post-Operative Effect After The Augmentation Mammaplasty With Pectoralis Major Injeected Botulinum Toxin A

The augmentation mammaplasty is one of the cosmetic and plastic operation to change body-curve, and this technology is more and more popular recently, with the improvement of prosthetic materials and the technology ripening, since the silica gel are used for augmentation mammaplasty. But the contracture of fibrous capsule, the deformity, firmness, pain, prosthesis exposure and even necrosis of mammary skin, those of complications affect the result greatly. On the basis of studies abroad, 1)After the pectoralis major were infilted with botulinum toxin A to repair the developed tethering at the lower border of brest after augmentation mammaplasty, the symptoms alleriated obviously. 2) Botulinum toxin A could change the hypertrophic scar.【Objective】: This method was to observe the changes of the fibrous capsule thickness and the post-perative brest shape.【Method】: 40 cases accepted augmentation mammaplasty with silica gel. During the operation, the test group were injected with BOTOX A, the control group were not injected with BOTOX A.1. B ultrasoud was used to examine mammary gland routinely and measured the thickness of pectoralis major.2. The patients returned in 3months, 6months and 12months post-operative.3. Observed the entire breast shape, measured the thickness of fibrous capsule and pectoralis major with B ultrasound.4. Clinical assessment was made to the breast with Baker class.【Result】:1.Thickness of fibrous capsule: the thickness of control group in different periods was more thick than the test group, p<0.05; the thickness of pectoralis major: the thickness of control group in 3 months post-operative were more thick than the test group, p<0.05.2. Baker class: one case with bilateral and two cases with single fibrous capsule contracture were grade II, the contracture rate was 4/32*100%=12.5% in the test group; one case with bilateral sides and two cases with single side were grade II, and one case with contracture in left side was grade III and right side was g rade II, the contracture rate was 6/30*100%=20%, p<0.05.3. The relationship between Baker class and thickness of fibrous capsule: Baker I:0.31-0.94mm;Baker II:1.12-1.41mm;Baker III:1.56-1.63mm,it had positive correlation, p<0.05.4. The entire breast shape: the test group, the good effects could be exist in the average 3 months, which the place of nipple could reach the middle of entire breast; the control group , the nipple place located below the middle of breast, and the place moved little with the time, p<0.05.【Conclusion】: BOTOX A could make the breast shape more natural in early period and diminish the thickness of capsule . the mechanism may be the chemi-denervation of botox A to the pectoralis major , and the relaxation of muscle could reduce the pressure around the prothesis and the drag action to the fibrous capsule .