垂直切口内上蒂法治疗不对称乳房肥大

摘要

目的 探讨应用垂直切口内上蒂法乳房缩小成形术治疗女性不对称乳房肥大的方法 及效果.方法 回顾性分析2012年5月至2018年11月浙江大学附属邵逸夫医院整形外科收治的31例双侧不对称乳房肥大病例资料,患者均为女性,年龄28～55岁,平均37.8岁.采用垂直切口内上蒂法行乳房缩小成形术,根据术前设计去除蒂部表皮,切除多余的皮肤及腺体组织,向上旋转内上蒂并固定于胸大肌筋膜,固定乳头、乳晕后逐层缝合.结果 术后随访(8.4±3.0)个月,时间范围6～18个月,29例患者对术后乳房形态及对称性满意,1例患者术后6个月出现轻度下垂,经过二期修复后双侧乳房形态良好,患者基本满意,1例患者因术后6个月出现瘢痕增生而不满意.结论 对于不对称乳房肥大患者,应充分评估乳房下垂和肥大程度,并以此设计双侧新乳头的位置,才能在乳房缩小的同时恢复双侧乳房的对称性.%Objective To evaluate the effect of vertical incision with superomedial pedicle for the treatment of female asymmetric hypermastia.Methods The total of 31 patients with asymmetric breast hypertrophy were admitted from May 2012 to November 2018.All patients were female with an average age of 37.8 (28-55) years.Mammoplasty was performed by vertical incision with superomedial pedicle.According to the preoperative design,the epidermis of the pedicle,the excess skin and glandular tissue were removed.The superomedial pedicle was rotated upward and to be fixed on the major pectoralis fascia.After the fixation of the nipple areola,the incision was closed.Results The mean follow up was (8.4±3.0) months,with a range from 6 to 18 months.One patient was unsatisfied with scar hyperplasia.One patient had slight mastoptosis 6 months after operation and received favorable outcome after revision.The rest of 29 patients had satisfactory results.Conclusions For patients with asymmetric breast hypertrophy,the new location of nipples on both sides should be determined by the degree of mastoptosis and hypermastia.So that,symmetry breast as well as smaller breast can be obtained.