双环法乳房固定加假体隆乳治疗乳房下垂的临床体会

Clinical experience of bi-loop mastopexy plus prosthetic breast augmentation in the treatment of breast ptosis

目的 针对哺乳后乳房皮下脂肪减少、腺体组织萎缩、乳头乳晕复合体下垂及皮肤组织多余等症状,彻底改善乳房萎缩下垂症。方法 自2015年至今,本科采用经乳晕双环法切口,环形切除松垂皮肤,分离腺体和胸大肌,形成双平面腔隙,上1/3位于胸大肌后,下2/3位于腺体后;植入合适规格的乳房假体,沿外环切口分离腺体包膜层达乳腺基底,上提松垂腺体组织并塑形固定缝合,治疗乳房下垂症130例。结果 术后随访3~24个月,4例出现不同程度的包膜挛缩,9例术后乳晕形态不佳,再次修复后满意,14例乳晕切口瘢痕增生,余病例无明显手术并发症。结论 采用双环法乳房固定加假体隆乳术治疗哺乳后乳房中、重度下垂症,术后乳房松垂改善明显,形态完美,环乳晕瘢痕轻,患者满意度高。

Objective To completely improve breast atrophy and ptosis by treating the symptoms of breast subcutaneous fat loss,glandular tissue atrophy,nipple-areola complex ptosis,and excess skin tissue after breastfeeding.Methods Since 2015,the undergraduate has used a double-ring incision through areola to rescinate the loose hanging skin,separate the glands and pectoralis major muscle,and form a bi-plane space,with the upper 1/3 behind the pectoralis major muscle and the lower 2/3 behind the glands.130 cases of breast ptosis were treated with breast prosthesis of suitable size,and the gland envelope was separated from the base of the mammary gland along the incision of the outer ring.Results During the follow-up period of 3 to 24 months,4 cases had capsule contracture of different degrees,9 cases had poor areola shape but were satisfied after repair,14 cases had areola incision scarring,and the other cases had no obvious complications.Conclusion Bi-loop mastopexy plus prosthetic breast augmentation is used to treat moderate and severe breast ptosis after breastfeeding,which provides significant improvement of breast ptosis,perfect shape,less scarring around the areola and high patient satisfaction.