乳晕内皮下复合组织瓣交叉填充联合持续牵引矫治中度和重度乳头内陷

Correction of moderate and severe inverted nipple with subcutaneous composite flaps by crossed filling and supporting within areola combined with continuous distraction

目的 探讨乳晕内皮下复合组织瓣交叉填充联合持续牵引治疗中度和重度乳头内陷的临床效果.方法 对33例（59只）中度和重度乳头内陷者,以乳头基底部为蒂,在两侧乳晕内皮下掀起三角形复合组织瓣,通过乳头下隧道交叉推进转移至对侧填充支撑乳头,术后持续外牵引2～4周,随访6个月至3年,评价临床效果和并发症.结果 术后均未发生乳头血运障碍.54只乳头内陷完全矫正,无复发,无乳头、乳晕坏死等并发症,医患双方对矫正后的乳头外观满意.结论 采用乳晕内皮下复合组织瓣交叉填充并辅以持续弹性外牵引复位后的内陷乳头,操作简单,创伤小,切口瘢痕隐蔽,疗效可靠,是较为理想的乳头内陷矫治方法.

Objective To explore the effect of subcutaneous composite flaps by crossed filling and supporting within areola combined with continuous distraction on moderate and severe inverted nipple.Methods 33 patients with 59 moderate and severe inverted nipples were involved in this study.The bilateral subcutaneous triangular composite tissue flaps pedicled with the base of the nipple were harvested within areola,the two triangular composite tissue flaps were revolved and advanced either horizontally to the opposite pedicle through the tunnel beneath the nipple and fixed as supporting.After the operation,the continuous distraction of the nipple lasted for two to four weeks,clinical effect and complications were analyzed.Results None of these 59 nipples appeared blood circulation disorder after operation.Postoperative follow-up for 6 months to 3 years showed that 54 inverted nipples were corrected completely without complications,such as nipple and areola necrosis,and there were no recurrence.The patients and doctors were satisfied with the appearance of the nipples.Conclusions Correcting the moderate and severe inverted nipple with subcutaneous composite flaps by crossed filling and supporting within areola combined with continuous distraction is simple,microinvasive,effective,and the incision scar is invisible,and it therefore is an ideal method for correcting the inverted nipple.