修复韧带和保留T4肋间神经的巨乳缩小术  

Reduction mammaplasty with repair of ligament and reserve of T4 intercostal nerve

作　　者：黄岩[1] 洪帆[1] 刘歆 纪工荣[1] 汪丽玲[1] 修志夫[1] 

机构地区：[1]厦门大学附属中山医院整形外科,厦门361004 [2]厦门闽海医院

出　　处：《中华医学美学美容杂志》2011年第2期81-83,共3页Chinese Journal of Medical Aesthetics and Cosmetology

摘　　要：目的 探讨一种能保留T4肋间神经和血管韧带的重塑锥体形乳房的巨乳缩小术.方法 对18例轻、中、重度巨乳者,乳腺组织切除选择在乳房中线上、下极部形成中央蒂,蒂部保留了内外侧深浅韧带、T4肋间神经外侧皮支深浅支.蒂部旋转移位固定,缩小乳房基底,增强韧带张力.二瓣法旋转皮瓣从内到外缩小乳房.保留T4肋间神经走行区真皮层以保护其浅支,旋转固定后起到纤维隔的作用.结果 术后乳头乳晕血供和感觉良好,乳房外形挺拔.随访3个月至2年,平均7个月.随访达1年者,瘢痕已不明显,外观无明显改变,患者满意.结论 修复韧带和保留T4肋间神经的巨乳缩小术设计简单,手术时间缩短,术后乳房外形挺拔稳定.Objective To discuss the reduction mammaplasty procedures by reserving the T4 nerve and blood vessels and by repairing the ligament for macromastia patients. Meths Eighteen cases of macromastia were enrolled in this study. The supeior and inferior polar portions on the median line of the breast were dissected to form a central pedicle. Outside deep and fleet branches of the ligament were repaired and the lateral deep and fleet branches of the 4th intercostal nerve reserved in the pedicle. The pedicle was revolved and fixed, the fundus of breast was reduced and the tensile force of the ligament was enhanced. The operation of two-flap rotated flaps reduced the breast volume from inside to the outside. The corium where T4 intercostal nerve distributed skin was reserved to protect the fleet branches of the nerve, and then rotated and fixed to act as a fibrous septum. Results After the operation, the blood vessel and feeling of nipple-areola complex were all satisfactory and the profile of breast was tall and straight. Follow-up from 3 months to 2 years （7 months in average） showed that the scar was unconspicuous, the appearance of the breast was not evidently changed and the patients were satisfactory. Conclusion It is a simple and well-designed procedure of reduction mammaplasty for macromastia with repaired ligment and reserved 4th intercostal nerve. The breast profile is tall and straight after the operation.

关 键 词：韧带 肋间神经 巨乳房 乳房缩小成形术 

分 类 号：R655.8[医药卫生—外科学]