乳房下垂矫正术中的乳房悬吊结构重建  

Reconstruction of breast suspensory structure for correction of breast ptosis

作　　者：李比[1] 夏有辰[1] 张洁[1] 毕洪森[1] 尤维涛[1] 牛星焘[1] 

机构地区：[1]北京大学第三医院成形科,北京100083

出　　处：《中国微创外科杂志》2006年第10期766-768,共3页Chinese Journal of Minimally Invasive Surgery

摘　　要：目的总结用乳房悬吊结构重建方法矫正轻、中度乳房下垂的临床经验。方法通过乳晕边缘切口，去除上半腺体后松弛的浅筋膜深层，上提腺体至正常位置并固定于深筋膜，腺体浅面按真皮乳罩原理进行悬吊并适当切除乳晕周边多余皮肤，或采用聚丙烯单丝网片对腺体进行悬吊，术后腺体周围形成强大的纤维粘连，从而重建乳腺的悬吊支持结构。同时进行腺体的适当折叠塑形或置入乳房假体增加丰满程度。结果共行轻、中度下垂32例手术（其中单纯悬吊10例，悬吊同时假体隆乳20例，采用聚丙烯网片悬吊2例），手术时间90～150min，平均110min。术中出血量30～100ml，平均58ml。均未发生乳头乳晕坏死感觉障碍等并发症。术后随访6～12个月，平均11．3月，术后外形改善满意率90．6％（29／32）。结论对于不伴腺体肥大的乳房轻、中度下垂，采用乳房悬吊结构重建，是一种创伤相对小，安全，有效的矫正方法。Objective To summarize clinical experience of reconstruction of breast suspensory structure in correction of mild-to-moderate breast ptosis. Methods Through a periareolar incision, the flabby deep layer of the superficial fascia beneath the upper breast gland was completely removed. Then the gland was lifted up to the normal position and the superior pole of the gland was fixed to the pectoral fascia at the second intercostal space. By using the dermal bra technique, an appropriate amount of skin was excised, and the dermis was fixed to the anterior surface of the breast gland. Or a monofilament polypropylene mesh was implanted and fixed to the anterior or posterior surface of the upper breast gland. Postoperatively, remarkable scar fibrosis reaction developed to form strong supporting structures just like natural ones. Glandular plication or implant augmentation was simultaneously employed to enhance the projection, if necessary. Results A total of 32 cases of mild-to-moderate breast ptosis was treated with this technique, including 10 cases of mastopexy only, 20 cases of mastopexy with implant augmentation, and 2 cases of mastopexy using monofilament polypropylene mesh. The operation time was 90～150 min （mean, 110 min）. The intraoperative blood loss was 30～100 ml （mean, 58 ml）. No complications such as nipple or areola necrosis or sensory disturbance were found. Follow-up observations for 6～12 months（mean, 11.3 months） showed a satisfactory rate of 90.6% （29/32）. Conclusions Reconstruction of breast suspensory structure is a simple, safe, and effective method for correction of mild-to-moderate breast ptosis without hyperplasia of mammary glands.

关 键 词：乳房下垂 乳房悬吊结构 乳房悬吊上提术 

分 类 号：R655.8[医药卫生—外科学]