双环法结合双“V”形乳腺切除法在乳房肥大整形术中的应用

Clinical application of round block technique combined with two "V" shaped resection in breast hypertrophy

目的：探讨双环法结合双＂V＂形乳腺切除法在乳房肥大整形术中的应用。方法：以乳头为中心设计两个环形切口,去除环形切口间的表皮,根据乳腺肥大情况在乳腺的上下垂直反向设计两个＂V＂形乳腺瓣,＂V＂形切除乳腺组织,在乳腺基底部适当分离后拉拢缝合乳腺。将去除表皮的真皮帽边缘与乳腺基底部筋膜缝合固定于胸大肌筋膜,留置负压引流管,沿外环内侧在真皮深层行连续荷包缝合,最后间断缝合切口皮肤。结果：所有受术者均未出现乳头、乳晕或乳房皮肤坏死、脂肪液化、血肿、感染、增生性瘢痕。术后随访3~18个月,切口瘢痕不明显,乳房外形对称,乳头、乳晕感觉良好。结论：双环法结合双＂V＂形乳腺切除法设计简单,易操作,瘢痕隐蔽,且能很好保留乳房感觉及泌乳功能,临床效果满意。

Objective To explore the clinical application of round block technique combined with two＂ V＂shaped resection in breast hypertrophy. Methods Two circular incisions were designed and the nipples were located in the center. The epidermis between the two circular was removed. Two ＂V＂ shaded breast flap should be designed upward and downward accordina to the situation of breasthypertrophy. The breast tissue was excised as ＂V＂shape and the incisions were sutured. The edge of dermis cap and breast basal fascia were fixed to the pectoralis major fascia. Drainage tube was indwellinged. We sutured the deeper dermis continuously along the inner side of the outer circular and placed interrupted sutures in the incision of skin. Results All cases recoverd without necrosis, fat liquefaction, hematoma, infection or hypertrophic scar after 3 to 18 months follow-up. The scars were not obvious and the breasts were in symmetrical shape.The founction of the nerves of nipples and areola was normal. Conclusion It＇s clinically satisfied for the advantages of simplicity, indistinction of scar and the retainment of founction.