乳晕环形及改良垂直切口法矫正65例乳房下垂的临床经验总结

Clinical summary of the circumvertical mastopexym and improved vertical incision in the correction of breast ptosis with 65 cases

目的 探讨应用乳晕环形及改良垂直切口法矫正乳房下垂的临床效果。方法 2017年1月至2019年12月,共收治65例乳房下垂患者,根据术前乳房下垂情况设计手术切口,均采用乳晕环形及垂直切口法成形术,形成蒂在上的真皮腺体瓣进行自我填充塑形,同时悬吊固定其余腺体,伴有乳房肥大的同时切除部分乳腺组织从150~380g不等,平均210g,乳晕切口采用荷包缝合法。结果 术后随访6~24个月,平均随访11.4个月,58例术后乳房外形挺拔,瘢痕不明显,均对外形满意,乳头乳晕感觉正常,无继发性下垂,术后未发生乳头乳晕坏死。4例原乳房下皱襞处皮下脂肪堆积,经简单脂肪抽吸术处理后外形满意;3例乳房脂肪液化,经换药、充分引流后治愈,未遗留明显瘢痕。结论 乳晕环形及垂直切口联合上蒂真皮腺体瓣,此方法操作简单、术后乳房外形良好、无继发性下垂、术后瘢痕小,对于乳房下垂伴或不伴乳房肥大具有可靠效果。

Objective to explore the clinical effect of the circumvertical mastopexym and improved vertical incision in correction of breast ptosis.Methods from 2017.1 to 2019.12,65 cases with breast ptosis were treated in our department.According to the preoperative breast ptosis,the surgical incision was designed.The circumvertical mastopexym and improved vertical incision were used in all patients.The dermal gland flap pedicled on the areola was formed for self filling and shaping.At the same time,the remaining glands were suspended and fixed.Part of the breast tissue was removed from 150 to 380g with breast hypertrophy.The average weight was 210g.the areola incision was made by purse string suture.Ressults The postoperative follow-up is about 6 months to 24 months,the average of which is 11.4 month.58 cases were satisfied with the appearance of straight breast without obvious scar,the nipple and areola were normal without secondary ptosis,and there was no nipple and areola necrosis after operation.Conclusion The circumvertical mastopexym combined with superior pedicle dermal gland flap is a simple and effective method with relatively short scar and good shape for correction of breast ptosis with or without breast hypertrophy.