乳腺囊性增生病乳腺全切除同期假体置入乳房整形术

Immediate Breast augmentation following entire gland removal in the patients with cystic mastopathy

目的:探讨弥漫性乳腺囊性增生病全乳腺切除同时置入硅胶乳房假体保持乳房外形的可能性。方法:经乳晕缘半环状切口,完整切除乳腺,胸大肌肌下分离形成合适大小腔隙,置入硅胶乳房假体,分层缝合胸大肌、皮下脂肪、真皮及乳晕皮肤。结果:8例患者手术创口一期愈合。本人及配偶对手术后外形均满意。皮下脂肪较丰满者,外观和触诊效果与一般隆乳者区别不明显。结论:中年女性双乳多发性结节及囊性肿块,特别是有乳癌家属史的高危人群,在乳腺全切除后置入硅胶乳房假体,在解除乳房的疼痛、阻断乳癌形成的可能进程的同时,保持乳房外形,减轻患者对乳腺切除后乳房外形破坏的心理负担。

Objective In order to explore the possibility of keeping the shape and profile of breasts with silicone implants after entire glands removal in the patients with extensive cystic mastopathy. Methods Through a conventional semiperiareola approach, mammary glands had been completely removed. Under the pectoralis major, a proper-sized cavity was created. And then, a mammary implant was put into it. The pectoralis major, the subcutaneous tissue, the dermis, and the skin of the periareola were sutured respectively. Results The incisions in eight cases were healed primarily. All the patients themselves and their spouses were satisfied with the result of the surgery. There was no obvious difference in inspection and palpation between the patients with entire gland removal plus silicone prostheses implanting and those who received mammary implantation only, especially in the plumpy cases. Conclusion For middle-aged females with multiple cystic mastopathy, especially for those who have family history of mammary cancer, it is advantageous to take a silicone implantation immediately after removal of entire glands. By doing so, not only pain in breasts and threat of possible mammary cancer disappeared, but also mammary contour remains.