环乳晕切口下蒂瓣法矫治巨大乳房

Correction macromastia by inferior pedicle around areola incision

目的：探讨环乳晕切口下蒂瓣矫正特别巨大乳房的临床效果.方法：采取环乳晕切口,以部分去表皮的下蒂瓣为基础,切除乳头乳晕上方、外侧大部分腺体皮肤及内侧部分腺体皮肤组织,上提下蒂瓣,固定重塑乳房腺体形态,再将下蒂两侧的皮肤均匀拉拢,覆盖下蒂瓣,切除多余皮肤,使之形成不超过乳房下皱襞的斜形短切口,乳晕及周围的皮肤真皮层辐射状环缩缝合,缝合皮肤.结果：10例20只乳房,单侧乳房组织平均切除量为1 050g,最大2 200g.随访6～12个月,无乳头坏死、感觉良好,外形饱满.患者对乳房形态、对称性、乳晕大小形状、乳头乳晕感觉及切口瘢痕的满意率分别为100％.结论：环乳晕切口下蒂瓣的巨大乳房缩小整形术,组织切除量大,瘢痕短,并发症少,是一种较好的巨大乳房缩小术式.

Objective To explore using the inferior pedicle to correct the macromastia around areola mamae incision.Methods Using the inferior pedicle with a part cuticle reduction as the base,we cut in around areola mamae,and removed a large part of gland skin outside and at the top of the nipple and areola mamae,including small amount inside.Then,upgrade the inferior pedicle,fix and rebuild the breast gland,cover the inferior pedicle with the skin two sides smoothly,cut spare skin in order that the oblique incision will not beyond the submamary fold,stitch the dermis and areola mamae constrictly and radially.Results The average one side breast tissues reduction of 10 cases （20 breasts） was 1 050g,maximum 2 200g.Followed-up in 6～12months after operation,there was no nipple necrosis and had normal sensitivity.All patients were satisfied with the operation.Conclusion the proper using of inferior pedicle in the reduction mammaplasty around areola incision can remove a large amount of tissue,has less complications with short scar.It is a perfect reduction mammoplasty.