Sehr geehrter Frau Dr. Berger, Sehr geehrter Herr Dr. Wolter,
auch wenn dieser Beitrag schon etwas älter ist, möchte ich hier gerne doch noch mal Antworten, da es mittlerweile Studien gibt, die Ihrer beider Aussagen ( Studien ) bzgl. des Sentinel-Nodes widerlegen. Es wäre auch durchaus hilfreich, wenn man solche Aussagen wie hier getätigt wurden, mit Studien belegen könnte und nicht einfach etwas niederschreiben und dadurch die Patienten verunsichert.
Doch hier nun das Wichtigste zum nachlesen:
Evaluation of the Effects of Transaxillary Breast Augmentation on Sentinel Lymph Node Integrity; Ana C Weck Roxo, Jose H Aboudib, Claudio C De Castro, Maria L De Abreu, and Margarida M Camões Orlando; Aesthetic Surgery Journal May 2011 31: 392-400, doi:10.1177/1090820X11404399
The prospective study enrolled 27 patients who underwent preoperative mammary lymphoscintigraphy, a subsequent TABA (using a subglandular placement of round, textured, high-profile silicone implants through a 4-cm incision at the anterior axillary fold), and postoperative lymphoscintigraphy at 21 days and six months after the procedure. The postoperative imaging results examining the axillary lymphatic chain and the first axillary lymph node were analyzed and compared to the preoperative images.None of the patients showed any changes between the preoperative and postoperative images at six months. Only one of the 27 patients (4.5%) demonstrated a lower rate of lymphatic drainage at 21 days postoperatively compared to preoperative values.The sentinel lymph node remained visible in all patients at all time points, and all breasts showed drainage primarily to the axillary lymphatic chain.Their data showed preservation of lymphatic drainage and visible sentinel lymph nodes even after transaxillary breast augmentation. I would love a larger study to confirm, but am pleased they looked at this.
Hier zunächst von der aktuellen Seite in Schweden als Info über
Brustvergrößerungen in der axilläre Zugang als aktuelle Methode erwähnt wird:
Sweden breast augmentation - the implants
There are three possible areas for the insertion of an implant for augmentation. The lower fold of the breast is the most common site. It allows full excess and lives a hidden scar. The second site is through the areola. This incision gives the best esthetic results but it is also the only one that goes through the breast tissue therefore the risk of infection and sensation loss is higher. The third one is through the armpits. Some plasit surgeons prefer it because the scar is almost invisible (except for those women who like to wear open close with no sleeves(. The disadvantage of this incision is a slight asymmetry of the breast. The decision usually made individually with each woman and the plastic surgeon (consult local Sweden surgeons).
Hier eine relativ aktuelle Studie mit einer Unersuchung von 1988 -2009, Erscheinnung also nach 2009
In der Studie aus Schweden werden nur Vorteile gesehen, Studie von 1988 bis 2009:
Improvements in transaxillary breast augmentation.Niechajev I.SourceLidingö-kliniken, Torsvägen 30, 181 32, Lidingö, Stockholm, Sweden. info@lidingokliniken.seAbstractBACKGROUND:Roughly 90% of breast augmentations are done through the submammary approach, yet patients, given the choice, sometimes choose the transaxillary approach, with the inconspicuous scar hidden in the axilla. Because the transaxillary approach is technically demanding and is performed relatively rarely, many plastic surgeons never master the technique.METHODS:From 1988 to 2009, 140 patients underwent transaxillary breast augmentation by the author, who developed several innovations and improvements for planning of this operation, its technical execution, and postoperative care. Among these innovations are a new implant selection system, the "boomerang incision," the technique for inserting anatomic teardrop-shaped implants through the axilla, submuscular and subfascial implant placement, a new instrument called the breast implant pusher, and use of intermittent regional postoperative analgesia.RESULTS:Implementation of the aforementioned modifications and innovations improved the overall quality and consistency of surgical results. It was proved that anatomically shaped breast implants could be inserted through the axillary incision and correctly positioned in the subfascial and submuscular location. The transaxillary technique is contraindicated for patients with ptotic, asymmetric, or tubular breasts.CONCLUSION:Transaxillary augmentation mammaplasty without routine endoscopic assistance is a safe method with predictable results and a high rate of patient satisfaction. The transaxillary technique offers the advantage of locating the surgical scar off the breast. It requires closer supervision during the first few postoperative months compared with the submammary or periareolar technique because it is more difficult to place and maintain implants at the proper level using the transaxillary approach.
Dann eine aktuelle Seite einer Klinik in Schweden, die auf den Zugang spezialisiert ist, hier der link:
[Link anzeigen]u.s.w.
Doch ein Verbot o.ä. für Schweden kann ich nicht finden?
Sollten solche Aussagen getätigt werden ist es von daher immer sehr sehr Sinnvoll einen Quellennachweis darzulegen, wie es sich auch gehört, dass aber nur mal am Rand erwähnt.
In diesem Sinn
annonase