Relação entre pressão e perda de volume mamário na mamoplastia de aumento

Abstract

The breast parenchyma dynamically interacts with an inserted implant, causing changes in vascular tissue and lactation, sensory involvement and local atrophy. The latter is associated with a reduction in breast volume over time. Previous studies have shown that larger implants with greater local pressure would lead to more intense compression of the parenchyma compared to smaller implants. In this study, we verified the pressure exerted by silicone implants of varying sizes with a degree of breast volume loss, in order to assess and relate whether changes in the volume of the breast parenchyma are proportional to the pressure variations due to the difference in the sizes of the implants. For that, 36 women were selected, divided into three groups (n = 12) and submitted to augmentation mammoplasty in the subglandular plane. The pressure measurement in millimeters of mercury was made with the aid of molds based on the projection of the implants introduced later. Magnetic resonance imaging was performed at three different times; in the preoperative period, at six and 12 months after surgery. The pressures were classified as low, medium and high, and related to the percentage of decrease in the volume of the implants, verified using the Friedman statistical test. The relationship between the pressure levels exerted and the loss of breast volume was demonstrated using the Kruskal-Wallis test. The results point to a significant difference in volume loss between the three pressure levels established by the implant, especially at the high pressure level compared to the low and medium pressure, concluding, therefore, that the pressure exerted by the implant was shown to be related to a decrease of breast volume.