摘要目的:探讨内窥镜辅助Ⅱ、Ⅲ型双平面技术在腋窝入路假体隆乳术的优势及重要性。方法:2018年10月至2020年10月，上海悦目佳容医疗美容门诊要求行隆乳术女性患者49例，年龄18~45岁，平均38.7岁。在乳房下皱襞上方离断胸大肌后，用自制的反向剥离器将胸大肌断端上方乳腺组织从胸大肌上松解分离，形成Ⅱ、Ⅲ型双平面。结果:49例患者随访13~24个月，其中31例先天性乳房发育不良和哺乳后乳腺萎缩患者，术后均获得较理想的乳房外形和手感，尤其是乳房下极的饱满度，未见假体包膜挛缩，无血肿、感染等并发症发生。18例伴有下极缩窄和(或)下垂乳房得到基本矫正。结论:自制反向胸大肌剥离器改变手术操作的力学方向，轻松分离松解胸大肌，形成Ⅱ、Ⅲ型双平面隆乳效果，可改善乳房下极饱满度，增加乳房曲线丰盈度，达到符合美学比例的乳房效果。

abstractsObjective:To discuss the advantages and importance of endoscope assisted type Ⅱ and type Ⅲ biplane technique in axillary augmentation mammoplasty, and to summarize the operation points and improvement.Methods:There were 49 patients enrolled in our study. After the posterior space of pectoralis major was formed and the pectoralis major was severed above the lower breast fold, the breast tissue above the broken end of pectoralis major was released and separated from pectoralis major by a self-made reverse stripper to form type Ⅱ and type Ⅲ biplane.Results:All the patients were followed up for 13-24 months. All cases got ideal breast shape and feeling, especially the plumpness of the lower breast pole. There was no capsular contracture, hematoma, infection and other complications. The breast with lower pole narrowing and/or sagging was basically corrected.Conclusions:The application of self-made reverse pectoralis major stripper can change the mechanical direction of the operation, easily separate and release the front of pectoralis major muscle, and form the exact type Ⅱ biplane, or even type Ⅲ biplane breast augmentation effect. It can further improve the stretching of the lower breast fullness, increase the fullness of the breast curve, and achieve the breast effect of aesthetic.