双环形切口内上侧蒂巨乳缩小术的临床观察

Clinical observation of superomedial pedicle combined with double-circle incision in reduction mammaplasty

目的探讨双环形切口内上侧蒂巨乳缩小术在临床中的应用效果。方法自2016年11月至2019年1月,对收治的33例巨乳症患者采用双环形切口内上侧蒂巨乳缩小术,术中切除乳腺外侧及部分上极腺体,保留内上象限脂肪腺体组织为蒂,将原乳头上提并固定于新设计的乳头位置,乳晕周围行荷包缝合,进行乳房塑形。结果本组33例患者,术后随访6~12个月,效果总体满意度较高。其中1例发生脂肪液化,经2次清创引流后愈合;1例右侧乳房出现部分乳头、乳晕坏死,考虑为过度折叠内上蒂所致;未发生感染和乳头感觉消失等并发症,乳房外形较好。结论采用双环形切口内上侧蒂巨乳缩小术,术后乳沟较明显,乳房上极饱满、形态较好,且瘢痕不明显。

Objective To explore the clinical application efficacy of superomedial pedicle combined with double-circle incision in reduction mammaplasty.Methods From November 2016 to January 2019,33 patients underwent superomedial pedicle combined with double-circle incision for reduction mammaplasty.During the operation,the lateral and part of upper mammary glands were resected.The adipose glands in upper inner quadrant were retained as pedicle,then the original nipple was lift and fixed to the position of new nipple.Purse string suture was performed around the areola.Results The overall satisfaction of postoperative efficacy was high.Fat liquefaction occurred in 1 patient and healed after 2 times of debridement and drainage.Partial necrosis of nipple and areola of right breast occurred in 1 patient,which was considered as the result of overfolded internal superior pedicle.No complications such as infection and nipple sensation disappearance occurred.The follow-up was ranged from 6 to 12 months,patients were satisfied with the appearance.Conclusion The application of superomedial pedicle combined with double-circle incision in reduction mammaplasty could obtain obvious cleavage.The upper pole of breast was full,the appearance of breast was good and the scar was not obvious.