Hoʻonui i ka umauma: mālama i ka hypotrophy o ka umauma

HOAKAKA, KUMU A ME NA KUMU

Hoʻoholo ʻia ka Hypoplasia o ka umauma e ka nui o ka umauma i hoʻomohala ʻia e pili ana i ka morphology o ka mea maʻi. ʻO ia paha ka hopena o ka lawa ʻole o ka hoʻomohala ʻana o ka gland i ka wā ʻōpio a i ʻole ka lua o ka manawa me ka emi ʻana o ka nui o ka gland (ka hāpai ʻana, ka pohō kaumaha, nā maʻi hormonal, etc.). Hiki ke hoʻopili pū ʻia ka nele o ka leo me ka ptosis (he umauma "hoʻomoe" me ka hāʻule ʻana o ka ʻili, ka ʻili o ka ʻili, a me nā areola haʻahaʻa loa).

"ʻAʻole ʻike pinepine ʻia kēia malnutrition i ke kino a me ka psychologically e ka mea maʻi, ka mea i ʻike iā ia ma ke ʻano he hoʻouka ʻana i kāna wahine, e alakaʻi ana i ka loli i ka hilinaʻi iā ia iho a i kekahi manawa i kahi malaise hohonu, hiki ke hiki i kahi paʻakikī maoli. ʻO kēia ke kumu i manaʻo ai ka hana e hoʻonui i ka nui o ka umauma, i manaʻo ʻia he liʻiliʻi loa, ma o ka hoʻokomo ʻana i nā prostheses. »

Hiki ke hoʻokō ʻia i kēlā me kēia makahiki mai 18 mau makahiki. ʻAʻole i manaʻo ʻia ka mea maʻi liʻiliʻi i kūpono no ke ʻoki. Eia nō naʻe, hiki kēia i nā hihia o ka hypoplasia koʻikoʻi a i ʻole ka pōʻaiapili o ke kūkulu hou ʻana e like me ka umauma tubular a i ʻole ka agenesis umauma. ʻAʻole hiki ke uhi ʻia kēia kumu aesthetic maʻemaʻe e ka ʻinikua olakino. He liʻiliʻi wale nō nā hihia o ka agenesis umauma ʻoiaʻiʻo (ka nele i ka ulu ʻana o ka umauma) hiki i kekahi manawa ke manaʻolana no ke komo ʻana i ka Social Security ma hope o ka ʻae mua ʻana.

ʻO nā implants o ka umauma e hoʻohana ʻia nei he pūpū a me ka mea hoʻopiha. Hana mau ʻia ka envelopp me ka elastomer silicone. Ma ka ʻaoʻao ʻē aʻe, ʻokoʻa nā prostheses i kā lākou ʻike, ʻo ia hoʻi, i ka mea hoʻopiha i loko o ka pūpū. Manaʻo ʻia kahi implant i hoʻopiha mua ʻia inā hoʻokomo ʻia ka mea hoʻopihapiha ma ka hale hana (gel a / a i ʻole physiological serum). No laila, hoʻonohonohoʻia ka laulā o nā puke likeʻole e ka mea hana. Hoʻopihaʻia nā implants saline-inflated e ke kauka lapaʻau, hiki iā ia ke hoʻololi i ka nui o ka prosthesis i kekahi manawa i ka wā o ke kaʻina hana.

NA HANAU HOU HOU PIA I KA PILI

ʻO ka hapa nui o nā prostheses i hoʻokomo ʻia i kēia manawa ma Farani a puni ka honua i hoʻopiha ʻia me ka gel silicone.

"ʻO kēia mau implants, i hoʻohana ʻia ma mua o 40 mau makahiki, ua hōʻike ʻia ʻaʻole maikaʻi ʻole a hiki ke hoʻololi ʻia i kēia ʻano o ka ʻoki ʻana, no ka mea ua kokoke loa lākou i nā umauma maʻamau. Ua hele pū lākou i nā loli koʻikoʻi, ʻoi aku hoʻi i ka hopena o nā makahiki 1990, e hoʻoponopono i nā hemahema i hiki ke hoʻopiʻi ʻia. I kēia lā, ʻo nā implants āpau i loaʻa ma Farani e hoʻokō i nā kūlana kūpono a koʻikoʻi: ʻae ʻia ka hōʻailona CE (European Community) + ANSM (National Agency for the Safety of Medicines and Health Products). »

Loaʻa iā lākou kahi gel silicone palupalu i hoʻopuni ʻia e ka shell elastomer silicone wai, lōʻihi a maʻalahi hiki ke maʻalahi a i ʻole ke kikokikona (ʻoʻoleʻa). ʻO nā hoʻomaikaʻi koʻikoʻi i nā implants hou, e hāʻawi ana iā lākou i ka hilinaʻi nui, pili i nā pūpū ʻelua a me ka gel ponoʻī:

• nā pūpū, i kēia manawa me nā pā ikaika loa, e pale aku i ka gel mai "ke koko" i waho (ʻo ia ke kumu nui o nā pūpū) a ʻoi aku ka pale ʻana i ka ʻaʻahu;

• "Sticky" silicone gels, nona ka like me ka liʻiliʻi o ka wai, e hoʻemi nui i ka pilikia o ka laha ʻana i ka wā o ka haki ʻana.

Me kēia hoʻonui ʻana i ka hilinaʻi, ʻike ʻia ka hanauna hou o nā implants silicone e nā ʻano like ʻole i loaʻa i kēia manawa, e ʻae iā lākou e hoʻohālikelike ʻia i kēlā me kēia hihia. No laila, ma ka ʻaoʻao o nā prostheses pōʻai maʻamau, ua ʻike ʻia nā implants "anatomical", i hōʻike ʻia ma ke ʻano o kahi kulu o ka wai, ʻoi aʻe a i ʻole ka kiʻekiʻe, ākea a i waho paha. ʻO kēia ʻano nui o nā ʻano, i hui pū ʻia me kahi koho ākea o nā puke, hiki i kahi koho "hoʻokahi" o nā prostheses e hoʻopaʻa ʻia a hoʻololi ʻia i ka morphology o ka mea maʻi a me nā manaʻo pilikino.

NA ANO ANO EA

ʻO nā pūpū o nā prostheses i hana mauʻia i ka silicone elastomer, heʻokoʻa ka hoʻopihapiha. I kēia lā, ʻelua wale nō mau koho i ka silicone gel i ʻae ʻia ma Farani: Physiological serum: ʻo ia ka wai paʻakai (ʻo ia ka 70% o ke kino kanaka). Hiki i kēia mau prostheses ke "hoʻopiha mua" (ma ka hale hana) a i ʻole "inflatable" (e ke kauā i ka wā o ke kaʻa). Ma muli o kā lākou ʻike wai (ma mua o ka gelatinous), he ʻano like ʻole ko lākou, ʻoi aku ka nui o ka maʻalahi, ʻike ʻia nā "paʻi" a hiki ke loaʻa pinepine i nā pōʻino o ka deflation hikiwawe a i kekahi manawa. Hydrogel: ʻO kēia ka mea hou loa e ʻae ʻia e Afssaps ma 2005. He gel aqueous i haku mua ʻia me ka wai mānoanoa me ka derivative cellulose. ʻO kēia gel, ka mea iʻoi aku ka maʻamau maʻamau ma mua o ka paʻakai maʻamau, hoʻopili pūʻia e ke kino i ka wā o ka hakiʻana o ka membrane. ʻO ka mea hope loa, aia nā prostheses nona ka pūpū silicone i uhi ʻia me ka polyurethane, hiki ke kōkua i ka hōʻemi ʻana i ka hanana o nā hanana pūpū.

MAMUA O KA HANA

Ma muli o kēia ʻano anatomical, nā makemake a me nā maʻamau o ke kauka lapaʻau, a me nā makemake i hōʻike ʻia e ka mea maʻi, e ʻae ʻia kahi hoʻolālā hana. No laila, e hoʻoholo mua ʻia ka wahi o nā ʻōpala, ke ʻano a me ka nui o nā implants, a me ko lākou kūlana e pili ana i ka ʻiʻo (e ʻike i lalo). E hana ʻia ka hoʻāʻo koko preoperative e like me ka mea i kuhikuhi ʻia. E hele ka mea anesthesiologist i ke kūkākūkā ma mua o 48 mau hola ma mua o ka hana. Hoʻopaʻa ʻia ka hoʻokolohua X-ray o ka umauma (mammography, ultrasound). Manaʻo nui ʻia e hoʻōki i ka puhi paka ma ka liʻiliʻi o hoʻokahi mahina ma mua a hoʻokahi mahina ma hope o ka hana (hiki i ka paka ke hoʻopaneʻe i ka hoʻōla ʻana) Mai lawe i nā lāʻau me ka aspirin no nā lā he ʻumi ma mua o ka hana. E noi ʻia ʻoe e hoʻokē ʻai (mai ʻai a inu ʻole i kekahi mea) no ʻeono hola ma mua o ke kaʻina hana.

KE ANO O KA ANESTESIA A ME KE ANO O KA HOPE

Ke ʻano o ka maʻi anesthesia: ʻO ka pinepine kēia he anesthesia maʻamau maʻamau i ka wā e hiamoe loa ai ʻoe. I nā hihia kakaʻikahi naʻe, hiki ke hoʻohana ʻia ka anesthesia "makaʻala" (hoʻonui ʻia ka anesthesia kūloko me ka intravenous tranquilizers) (e like me ka ʻaelike me ke kauka lapaʻau a me ka anesthesiologist). Nā ʻano o ka hale maʻi: ʻo ka hana maʻamau e koi i kahi lā hoʻomaha. Hoʻokomo ʻia ke komo ʻana i ke kakahiaka (a i kekahi manawa i ka lā ma mua) a ʻae ʻia ka puka ʻana i ka lā aʻe. Eia naʻe, i kekahi mau hihia, hiki ke hana ʻia "ma kahi outpatient", ʻo ia hoʻi, me ka haʻalele ʻana i ka lā hoʻokahi ma hope o kekahi mau hola o ka nānā ʻana.

HOOLAHA

Hoʻohana kēlā me kēia kauka lapaʻau i kāna ʻenehana ponoʻī a hoʻololi iā ia i kēlā me kēia hihia i mea e loaʻa ai nā hopena maikaʻi loa. Eia naʻe, hiki iā mākou ke mālama i nā loina maʻamau: ʻO ka ʻili ʻili: aia kekahi mau "hoʻokokoke" hiki.

• nā ala ea areola me ka ʻoki ʻana ma ka ʻāpana haʻahaʻa o ka pōʻai areola a i ʻole ka puka ākea a puni ka nipple mai lalo (1 a me 2);

• axillary, me kahi ʻoki ma lalo o ka lima, ma ka ʻāʻī (3);

• ke ala submammary, me kahi ʻoki i loko o ke awāwa aia ma lalo o ka umauma (4). ʻO ke ala o kēia mau ʻokiʻoki e pili pono ana i kahi o nā ʻōpala e hiki mai ana, no laila e hūnā ʻia ma nā hui a i ʻole i nā ʻāpana kūlohelohe.

Ke kau ʻana o nā prostheses

Ke hele nei i nā ʻoki, hiki ke hoʻokomo ʻia nā implants i loko o nā ʻeke i hana ʻia. Hiki i nā kūlana ʻelua:

• premuscular, kahi e kū pono ai nā prostheses ma hope o ka ʻili, i mua o nā ʻiʻo pectoral;

• retromuscular, kahi i loaʻa ai nā prostheses i ka hohonu, ma hope o nā ʻiʻo pectoral.

ʻO ka koho ma waena o kēia mau pūnaewele ʻelua, me ko lākou mau pono a me nā hemahema, pono e kūkākūkā me kāu kauka. Nā Hana Hoʻohui I ka hihia o ka hui pū ʻana (ka umauma umauma, nā areola haʻahaʻa) ua ʻike mākou he mea makemake paha e hoʻemi i ka ʻili o ka umauma i mea e piʻi ai ("mastopexy"). ʻO ka ʻoki ʻana o ka ʻili e loaʻa i nā ʻōpala nui aʻe (a puni ka areola ± pololei). ʻO nā ʻauwai a me nā ʻaʻahu Ma muli o nā maʻamau o ke kauka lapaʻau, hiki ke kau ʻia kahi wai liʻiliʻi. Hoʻolālā ʻia kēia mea hana e hoʻokaʻawale i ke koko e hōʻiliʻili ʻia a puni nā prostheses. I ka pau ʻana o ka hana, hoʻopili ʻia kahi bandage "modeling" me kahi bandage elastic. Ma muli o ke kauka lapaʻau, ka hoʻokokoke a me ka pono e hele pū me nā kaʻina hana hou, hiki ke kaʻina hana mai hoʻokahi hola a ʻelua a me ka hapalua hola.

MAHOPE O KA HANA: OPERATIONAL OBSERVATION

Hiki ke ʻeha ka papa postoperative i kekahi manawa i nā lā mua, ʻoi aku hoʻi me nā implants nui a ʻoi loa ke kau ʻia ma hope o nā ʻiʻo. ʻO ka lāʻau ʻeha i hoʻololi ʻia i ka ikaika o ka ʻeha e kuhikuhi ʻia no kekahi mau lā. ʻO ka maikaʻi loa, e ʻike ka mea maʻi i kahi manaʻo ikaika o ka haʻalulu. ʻO Edema (ka pehu), ecchymosis (bruising), a me ka paʻakikī o ka hāpai ʻana i nā lima he mea maʻamau i ka wā mua. Wehe ʻia ka bandage mua ma hope o kekahi mau lā. A laila hoʻololi ʻia me kahi kāʻei māmā. A laila no kekahi mau pule, hiki ke ʻōlelo ʻia ke komo ʻana i ka pale i ke ao a me ka pō. I ka hapanui o nā hihia, ʻo nā humuhumu i loko a hiki ke komo. A i ʻole, e holoi ʻia lākou ma hope o kekahi mau lā. Pono e hoʻihoʻi ʻia me ka hoʻomaha ʻana i nā hana no ʻelima a ʻumi mau lā. Pono e kali i hoʻokahi a ʻelua mahina e hoʻomaka hou i nā hana haʻuki.

HUAKAI

No ka loiloi i ka hopena hope loa, pono ka manawa o ʻelua a ʻekolu mau mahina. ʻO kēia ka manawa e loaʻa hou ai ka maʻalahi o ka umauma a hoʻopaʻa i nā prostheses.

"Ua ʻae ʻia ka hana e hoʻomaikaʻi i ka leo a me ke ʻano o ka umauma. ʻAʻole ʻike nui ʻia nā ʻōpala. ʻO ka hoʻonui ʻana i ka nui o ka umauma e pili ana i ka silhouette holoʻokoʻa, e hāʻawi ana i ke kūʻokoʻa nui aʻe i nā lole. Ma waho aʻe o kēia mau hoʻomaikaʻi kino, ʻo ka hoʻihoʻi ʻana i ka wahine piha a me ka wahine holoʻokoʻa he hopena maikaʻi loa ia ma kahi pae psychological. »

ʻO ka pahuhopu o kēia hana ʻo ka hoʻomaikaʻi ʻana, ʻaʻole ka hemolele. Inā ʻoiaʻiʻo kāu mau makemake, e ʻoluʻolu loa ka hopena iā ʻoe. ʻO ke kūpaʻa o ka hopena ʻAʻole paha ka makahiki o nā prostheses (e ʻike i lalo) a koe naʻe ka hoʻololi ʻana o ke kaumaha nui, e paʻa mau ka nui o ka umauma i ka wā lōʻihi. Eia naʻe, e pili ana i ke ʻano a me ka "paʻa" o ka umauma, e hoʻopili ʻia ka umauma "hoʻonui", e like me ka umauma maoli, i nā hopena o ka umekaumaha a me ka ʻelemakule ma nā helu like ʻole e pili ana i ka makahiki a me ka maikaʻi o ke kākoʻo o ka ʻili. e like me ka nui o ka umauma. implants.

KA POINO O KA HUA

I kekahi manawa hiki mai kekahi mau hemahema:

• ke koena volume asymmetry, hoʻoponopono ʻole ʻia ʻoiai nā implants o nā nui like ʻole; • ka nui o ka rigidity me ka lawaʻole o ka maʻalahi a me ka neʻe (ʻoi aku me nā implants nui);

• 'ano hana 'ano, oi loa aku i ka poe ma'i lahilahi, me ka 'ike nui 'ana o na lihi o ka prosthesis, oi loa aku ma ka mahele luna;

• Hiki ke hoʻopaʻa ʻia i ka paʻi ʻana o nā implants, ʻoi aku ka liʻiliʻi me ka mānoanoa liʻiliʻi o ka uhi kiko (ʻili + momona + hao) e uhi ana i ka prosthesis (ʻoi loa me nā implants nui).

• hiki ke hoʻonui i ka ptosis o ka umauma, ʻoi aku ka nui o ka hoʻohana ʻana i nā implants nui. Inā ʻaʻohe ʻoluʻolu, hiki ke hoʻoponopono ʻia kekahi o kēia mau hemahema e ka hoʻoponopono ʻana ma hope o kekahi mau mahina.

NA NINAU EA

Hāpai/Hōʻai

Ma hope o ka hoʻokomo ʻana i nā prostheses o ka umauma, hiki ke hāpai ʻia me ka ʻole o ka pilikia i ka mea maʻi a i ke keiki paha, akā pono e kali ma kahi o ʻeono mahina ma hope o ka hana. No ka hānai ʻana, ʻaʻole ia he pilikia a ma ka hapa nui o nā hihia hiki ke hiki.

Nā maʻi kaulike

ʻO ka nui o nā pepa ʻepekema honua i lawe ʻia ma ka laulā nui ma kēia kumuhana i hōʻike like ʻole i ka nui o ka pilikia o kēia ʻano maʻi laha i nā maʻi me nā implants (ʻoi aku ka silicone) ʻaʻole ʻoi aku ka kiʻekiʻe ma mua o ka heluna wahine.

Nā niho niho a me ke kanesa

- A hiki i kēia manawa, ua ʻōlelo ka mokuʻāina o ka ʻepekema ʻo ka hoʻokomo ʻana i nā prostheses o ka umauma, me nā mea silicone, ʻaʻole e hoʻonui i ka pilikia o ka ulu ʻana i ka maʻi maʻi umauma. ʻOiaʻiʻo nō ka hihia no nā ʻano maʻi maʻamau o ka maʻi maʻi umauma (adenocarcinomas, ʻaʻole i hoʻonui i ka maʻi me ka prosthesis umauma.

Eia nō naʻe, ma ke ʻano o ka nānā ʻana i ka maʻi kanesa ma hope o ka hoʻokomo ʻia ʻana, hiki ke hoʻopilikia ʻia ka hoʻokolohua lapaʻau a me ka palpation, ʻoi aku hoʻi ma ke ʻano o kahi puʻu periprosthetic a i ʻole siliconoma. Pēlā nō, hiki i ka hele ʻana o nā implants ke hoʻopilikia i ka hana a me ka wehewehe ʻana i nā mammograms screening, pono e hana mau ʻia. No laila, pono ʻoe e hōʻike mau iā ʻoe he mau implants umauma. No laila, ma muli o ka hihia, hiki ke hoʻohana ʻia kekahi mau loea radiological kūikawā (nā kikoʻī kikoʻī, nā kiʻi i hoʻopaʻa ʻia, ultrasound, MRI, etc.) Eia kekahi, i ka hihia o ke kānalua diagnostic e pili ana i ka maʻi kanesa o ka umauma, pono e ʻike kekahi i ka loaʻa ʻana o nā prostheses e koi aku i kahi hoʻokolokolo hou aʻe e loaʻa ai ka hōʻoia diagnostic.

- ʻO ka Anaplastic large cell lymphoma (ALCL) pili me nā implants umauma (ALCL-AIM) he ʻano lapaʻau kūʻokoʻa i hoʻopili ʻia i kēlā me kēia manawa. Pono e ʻimi wale ʻia kēia ʻano inā loaʻa nā hōʻailona lapaʻau i hōʻoia ʻia (ka hoʻoulu hou ʻana o ka periprosthetic, ʻulaʻula o ka umauma, hoʻonui ʻia ka umauma, palpable mass). A laila pono e hana i kahi loiloi senological pololei e wehewehe i ke ʻano o ka lesion. Ma kahi kokoke i 90% o nā hihia, he kūlana maikaʻi loa kēia maʻi a hoʻōla pinepine ʻia e ka lāʻau lapaʻau kūpono, e hui pū ana i ka wehe ʻana o ka prosthesis a me ka capsule periprosthetic (total and total capsulectomy). Ma kahi o 10% o nā hihia, ʻoi aku ka koʻikoʻi o ka pathology a koi aku i ka mālama ʻana me ka chemotherapy a / a i ʻole radiation therapy i loko o kahi hui kūikawā i ka mālama ʻana i nā lymphomas.

Ke ola lawelawe o nā implants

ʻOiai inā hiki iā mākou ke ʻike i ka mālama ʻana o kekahi mau maʻi i kā lākou implants no kekahi mau makahiki me ka ʻole o nā loli nui, ʻaʻole pono e noʻonoʻo ʻia ka hoʻokomo ʻana o nā prostheses o ka umauma he mea "no ke ola". No laila, hiki i ka mea maʻi me nā implants ke manaʻo e hoʻololi i kā lākou prostheses i kekahi lā i mea e mālama ai i kahi hopena maikaʻi. ʻO nā implants, ʻoiai paha lākou, he ola pau ʻole ʻaʻole hiki ke koho pololei ʻia no ka mea e hilinaʻi ana ia i ke ʻano o ka ʻaʻahu ma kahi ʻano loli. No laila, ʻaʻole hiki ke hōʻoia ʻia ke ola lawelawe o nā implants. Eia naʻe, pono e hoʻomaopopo ʻia ua holomua nui nā implants hanauna hou ma ke ʻano o ka ikaika a me ka hilinaʻi. Mai ka makahiki ʻumi, pono e hoʻāla i ka nīnau o ka hoʻololi ʻana i nā prostheses i ka wā e ʻike ʻia ai kahi hoʻololi o ke kūlike.

nānā

He mea nui ka hahai ʻana i nā hoʻokolohua i kauoha ʻia e kāu kauka lapaʻau no kekahi mau pule a laila mau mahina ma hope o ke kanu ʻana. Ma hope mai, ʻaʻole i hoʻokuʻu ʻia ka hele ʻana o nā implants mai ka nānā ʻana i nā lāʻau lapaʻau maʻamau (ka nānā ʻana i ka gynecological a me ka nānā ʻana i ka maʻi maʻi umauma), ʻoiai inā ʻaʻole ia e koi i nā hoʻokolohua hou e pili ana i kēia nānā. Eia naʻe, he mea nui e hōʻike i nā kauka like ʻole he mau pale umauma kou. Manaʻo ʻia kahi kūkākūkā me ke kauka lapaʻau e pili ana i nā implants i kēlā me kēia ʻelua a ʻekolu mau makahiki, akā ma waho o kēia hahai ʻana, ʻo ka mea nui ka mea nui e hele mai e kūkākūkā i ka wā e ʻike ʻia ai ka hoʻololi ʻana o hoʻokahi a i ʻole nā ​​umauma ʻelua. a i ʻole ma hope o ka ʻeha nui.

NA PILIKIKA PILI

ʻO ka hoʻonui ʻana i ka umauma me nā prostheses, ʻoiai ua hana ʻia no nā kumu aesthetic maʻemaʻe, akā naʻe he kaʻina hana ʻoki maoli e hiki mai ana me nā pilikia e pili ana i kekahi kaʻina lāʻau lapaʻau, ʻaʻohe mea liʻiliʻi. Pono e hoʻokaʻawale ʻia ma waena o nā pilikia e pili ana i ka anesthesia a me nā pilikia e pili ana i ka ʻoki ʻana: No ka anesthesia, i ka wā o ke kūkākūkā preoperative obligatory, ʻo ke anesthesiologist ponoʻī e haʻi i ka mea maʻi e pili ana i nā pilikia anesthetic. Pono ʻoe e ʻike ʻo ka anesthesia, ʻo kēlā me kēia mea, ke kumu i nā hopena i loko o ke kino i hiki ʻole ke ʻike ʻia i kekahi manawa a ʻoi aku ka maʻalahi a maʻalahi hoʻi. Eia nō naʻe, me ke kōkua ʻana o kahi mea hoʻomaʻemaʻe anesthesiologist-resuscitator mākaukau e hana ana i kahi pōʻaiapili maoli, ua lilo nā pilikia i haʻahaʻa loa. Pono e hoʻomanaʻo i ka holomua nui ʻana o nā ʻenehana, anesthetics, a me ka nānā ʻana i nā makahiki he kanakolu i hala aku nei, e hāʻawi ana i ka palekana maikaʻi loa, ʻoiai ke hana ʻia ka hana ma waho o ka lumi ulia pōpilikia a me ke kanaka olakino; E pili ana i ke ʻano o ke kaʻina hana, ma ke koho ʻana i kahi kauka lapaʻau kūpono a mākaukau i hoʻomaʻamaʻa ʻia i kēia ʻano hana, e kaupalena ʻoe i kēia mau pilikia e like me ka hiki, akā ʻaʻole e hoʻopau loa iā lākou. I ka hoʻomaʻamaʻa, ʻo ka hapa nui o nā hana hoʻonui umauma i hana ʻia i loko o nā lula e hele me ka pilikia ʻole, maʻalahi ka papa postoperative, a ʻoluʻolu loa nā mea maʻi i kā lākou hopena. Eia nō naʻe, i kekahi manawa hiki ke pilikia i ka wā o ka hana ʻana, pili kekahi o ia mau mea i ka ʻoki umauma, a ʻo nā mea ʻē aʻe e pili pono ana i nā implants:

Nā pilikia pili i ka ʻoki umauma

• Effusions, infection-hematoma: ʻO ka hōʻiliʻili ʻana o ke koko a puni ka prosthesis he pilikia mua ia e hiki mai ana i nā hola mua. Inā he mea nui kēia, a laila ʻoi aku ka maikaʻi o ka hoʻi ʻana i ke keʻena hana e hoʻokuʻu i ke koko a hoʻōki i ke kahe ʻana ma ke kahua o kona kumu;

- Serous effusion: ʻo ka hōʻiliʻili ʻana o ka wai lymphatic a puni ka prosthesis he mea maʻamau, hele pinepine ʻia me ka edema nui. He hopena wale nō ia i ka piʻi ʻana o ka umauma no ka manawa pōkole. Nalo koke a mālie;

– ka maʻi: kakaʻikahi ma hope o kēia ʻano ʻoki. ʻAʻole hiki ke hoʻoholo ʻia me ka lāʻau antibiotic wale nō a laila koi i ka hoʻoponopono ʻokiʻoki e hoʻokahe a wehe i ka implant no kekahi mau mahina (ʻo ka manawa e pono ai e hoʻokomo i kahi prosthesis hou me ka pilikia ʻole). Hiki ke ʻōlelo ʻia ʻekolu mau ʻano kikoʻī o ka maʻi:

- ka ma'i "noho malie" hope loa: he ma'i keia me ka li'ili'i o nā hō'ailona a 'a'ohe 'ike maopopo ma ka ho'okolokolo 'ana, hiki i kekahi manawa ke hana 'ia i kekahi mau makahiki ma hope o ke kanu 'ana;

- nā microabscesses: ulu pinepine ma ke kahua o ka suture a hoʻoholo wikiwiki ma hope o ka wehe ʻana i ke kaula i hoʻopaʻa ʻia a me ka mālama kūloko;

- Staphylococcal toxic shock: ua hōʻike ʻia nā hihia kakaʻikahi o kēia maʻi infectious maʻamau.

• ʻO ka necrosis maʻi ma muli o ka lawa ʻole o ka oxygenation o ke kino ma muli o ka lawa ʻole o ke koko i hoʻolako ʻia e ka hoʻoikaika nui ʻana, ka hematoma, ka maʻi, a i ʻole ka puhi paka nui i ka mea maʻi. He pilikia loa kēia akā pilikia, ʻoiai ma nā hihia koʻikoʻi hiki ke alakaʻi i ka ʻike kūloko o ka prosthesis, ma muli o ka ʻokoʻa o nā sutures. Pono pinepine ka hoʻoponopono hou ʻana, i kekahi manawa e pono ai ka wehe ʻana i ka implant.

• Healing anomalies ʻO ke kaʻina hana ho'ōla e pili ana i nā phenomena maʻamau, i kekahi manawa i ka wā lōʻihi ʻaʻole i ʻike ʻia nā ʻōpala e like me ka mea i manaʻo ʻia, a laila hiki ke lawe i nā ʻano like ʻole: dilated, retractile, soldered, hyper- or hypopigmented, hypertrophic (pehu ) a i ʻole keloid wale nō.

• Hoʻololi i ka ʻike. Hoʻomaka pinepine lākou i nā mahina mua, akā pinepine ka regress. Eia nō naʻe, i nā hihia liʻiliʻi, hiki ke hoʻomau ʻia kekahi degere o ka dysesthesia (hoʻemi a hoʻonui ʻia ka naʻau i ka hoʻopā ʻana), ʻoi aku ka nui ma ka areola a me ka nipple. • Galactorrhea/milk effusion Ua hōʻike ʻia nā hihia kakaʻikahi o ka hoʻoulu ʻana i ka hormonal postoperative me ka hopena o ke kahe waiu ("galactorrhea") me ka wai i kekahi manawa a puni ka prosthesis.

• Pneumothorax Rare, pono e lapaau kūikawā.

Nā pilikia e pili ana i nā implants

• ʻO ka hoʻokumu ʻana o "folds" a i ʻole ke ʻano o "nā nalu"Ma muli o ka maʻalahi o nā implants, hiki ke wrinke ko lākou pūpū, a hiki ke ʻike a ʻike ʻia paha kēia mau pelu ma lalo o ka ʻili i kekahi mau kūlana, e hāʻawi ana i ka manaʻo o nā nalu. He mea maʻamau kēia ʻano i nā poʻe maʻi wīwī a hiki ke mālama ʻia me ka lipomodelling, e pili ana i ka hoʻopili ʻana i kahi momona momona ma lalo o ka ʻili o ka umauma e "mask" i ka implant.

•"ʻO nā pūpū 

ʻO ka hopena physiological, maʻamau a mau loa o ke kino kanaka i ke alo o kahi kino ʻē e hoʻokaʻawale iā ia mai nā ʻiʻo a puni ma o ka hana ʻana i kahi membrane ea e hoʻopuni ana i ka implant a kapa ʻia ʻo "periprosthetic capsule". ʻO ka mea maʻamau, he lahilahi kēia pūpū, maʻalahi a ʻike ʻole ʻia, akā hiki ke hoʻoikaika ʻia ka hopena a mānoanoa ka capsule, lilo i fibrous a hoʻihoʻi hou, ʻomi i ka implant, a laila kapa ʻia ʻo "shell". Ma muli o ka ikaika o ka hanana, hiki i kēia ke alakaʻi i: kahi paʻakikī maʻalahi o ka umauma, i kekahi manawa he constriction hoʻonāukiuki, ʻoiai he deformity ʻike ʻia me ka globulization o ka prosthesis, kahi e alakaʻi ai i kahi pae kiʻekiʻe i kahi paʻakikī, ʻeha, ʻoi aʻe a liʻiliʻi paha. wahi eccentric. ʻO kēia fibrosis retractile i kekahi manawa ma muli o ka hematoma a i ʻole ka maʻi, akā i ka hapanui o nā hihia, ʻaʻole hiki ke ʻike ʻia kona hanana ʻana ma muli o nā hopena kūlohelohe.

I nā makahiki i hala iho nei, ua holomua ka holomua ma ke ʻano o ke ʻano o ke kaʻina hana, akā ma luna o nā mea a pau i ka hoʻolālā ʻana a me ke kūkulu ʻana i nā implants, e hopena i ka hoʻemi nui ʻana i ka wikiwiki a me ka ikaika o ka indentation. Inā pono, hiki i ka hana hou ke hoʻoponopono i kēlā ʻano ʻaelike ma ke ʻoki ʻana i ka capsule ("capsulotomy").

• ʻAha Ua ʻike mākou ʻaʻole hiki ke manaʻo ʻia nā implants paʻa. No laila, i ka wā lōʻihi, hiki ke nalowale ka paʻa o ka pūpū. Hiki iā ia ke porosity maʻalahi, pinholes, microcracks, a i ʻole nā ​​lua maoli. I nā hihia koʻikoʻi loa, ʻo ia paha ka hopena o ka ʻeha nui a i ʻole ka pōʻino pōʻino, a, ʻoi aku ka nui o ka hopena o ka hele ʻana o ka pā ma muli o ka ʻelemakule. I nā hihia āpau, alakaʻi kēia i kahi hopena o ka huahana hoʻopiha prosthesis, me nā hopena like ʻole e pili ana i ke ʻano o kēia ʻike:

- me ka saline a i ʻole ka resorbable hydrogel, ʻāpana a i ʻole ka hoʻopau piha ʻana, ʻike ʻia ka deflation wikiwiki a wikiwiki paha;

- me ka silicone gel (non-absorbable), noho ia i loko o ka membrane e hoʻokaʻawale i ka prosthesis. Hiki i kēia ke kōkua i ke ʻano o ka hull, akā hiki ke noho ʻole me ka hopena ʻole a ʻike ʻole ʻia. Eia nō naʻe, i kekahi mau hihia, ua lilo i mea maʻalahi (ʻo ia hoʻi, ma muli o ka "adhesion" ʻoi aku ka maikaʻi o nā gels hou), hiki i kekahi ke nānā i ke komo mālie ʻana o ka gel i nā ʻiʻo a puni. ʻO ka haʻihaʻi ʻana o ka prosthesis e koi pinepine i ka hana e pani i nā implants.

• Ke kūlana kūpono ʻole, kuhi hewa ʻO ke kūlana kūpono ʻole a i ʻole ke kuhi lua o nā implants, a laila pili i ke ʻano o ka umauma, hiki i kekahi manawa ke hōʻoiaʻiʻo i ka hoʻoponopono ʻana.

• Hoʻololi ʻOiai he kakaikahi ka hoʻololi ʻana o kahi prosthesis "anatomical" i ka hoʻomaʻamaʻa ʻana, hiki ke hoʻololi ʻia i ka hopena maikaʻi.

• Hoʻololi o ka paia o ka umauma. I nā hihia kakaʻikahi, hiki i nā prostheses pūpū fibrous i waiho ʻia no ka manawa lōʻihi ke "kau" i loko o nā ʻiʻo, e waiho ana i kahi deformity o ka pā umauma paʻakikī ke hoʻoponopono ke wehe ʻia.

• Seroma periprosthetic hope. I nā hihia koʻikoʻi loa, hiki ke hana ʻia kahi hoʻoheheʻe lohi a puni ka prosthesis. ʻO ia ʻano hoʻoheheʻe hope loa, ʻoiai inā pili ia me nā anomalies ʻē aʻe o ka mammary gland, pono i kahi loiloi senological e kahi radiologist senologist. ʻO ka loiloi kumu e komo pū me ka ultrasound me ka effusion puncture. ʻO ka wai i lawe ʻia ma kēia ʻano ke kumuhana o ka noiʻi ʻana me ka ʻimi ʻana i nā cell lymphoma. Pono paha ka mammography kikohoʻe a me / a i ʻole MRI ma muli o nā hopena o nā hoʻokolohua fibrous periprosthesis mua (capsulectomy) e ʻae ai i ka biopsy e ʻimi i ka lymphoma nui liʻiliʻi e pili ana i ka umauma implant-pili anaplastic (ALCL-AIM).