舌状乳腺组织瓣翻转矫正中度乳房下垂  

Correction of moderate mastoptosis with the upturned glandular flap

作　　者：何俭[1] 刘晓夏[1] He Jian;Liu Xiaoxia(Wuxi Maternal ＆ Child Health Hospital Affiliated with Nanjing Medical University, Wuxi 214002, China)

机构地区：[1]江苏省无锡市妇幼保健院整形美容科,214002

出　　处：《中华整形外科杂志》2018年第6期453-457,共5页Chinese Journal of Plastic Surgery

摘　　要：目的探讨矫正乳房下垂的新方法及临床意义。 方法取乳晕周双环切口，去除内外环间表皮，皮下广泛分离后，于乳腺下中位切取舌状乳腺组织瓣，将此瓣向后上翻转至乳腺后间隙，使乳晕区增高，将下部两侧腺体拉拢缝合。再于上方腺体正中纵向切开，适当分离后将内侧腺体瓣向外后方旋转，外侧腺体瓣向内前方旋转缝合固定，使整个乳房塑形成半球状。 结果2008年10月至2017年6月采用此法矫治中度乳房下垂共15例，切口均一期愈合，无血肿、感染、乳头乳晕坏死等严重并发症，乳房下垂得到有效矫正。术后随访3～24个月，下垂无明显复发，外形良好，切口瘢痕呈环线状，乳头乳晕感觉功能正常。手术前、后乳房测量数据：乳头间距为（20.43±1.22）cm，（19.73±0.80） cm，P〈0.05；胸骨上切迹至乳头中点间距左（23.03±0.99）cm，（20.40±0.71）cm，P〈0.05，右（23.17±0.94）cm，（20.43±0.70）cm，P〈0.05；乳晕直径左（4.97±0.55）cm，（4.63±0.68）cm，P〈0.05，右（4.97±0.50）cm，（4.57±0.50）cm，P〈0.05；乳房下极超过下皱襞的距离，左（2.70±0.36）cm，（0.22±0.38）cm，P〈0.05，右（2.77±0.44）cm，（0.22±0.38）cm，P〈0.05；经乳头胸围（84.29±1.81）cm，（87.83±2.22）cm，P〈0.05，差异均具有统计学意义。 结论舌状乳腺组织瓣翻转矫治乳房下垂的术式设计巧妙，操作方便，疗效确切，为矫正乳房下垂提供了一种新的选择。ObjectiveTo review and discuss the new method ology of mastopexy for moderate mastoptosis.MethodsPeriareolar double-circle incisions were made, and the epidermis between the incisions was removed.Separating was performed widely between subcutaneous tissue and gland tissue. The tongue glandular flap, which was made in the below portion of the breast glands, was transferred upward to the mammary space. Then, the glands on both sides of the lower pole of the breast tissue were sutured to shrink the glandular base area.Vertical incision was made in the middle line of the superior portion of the gland. The medial glandular flap was rotated outward, lateral glandular flap was transferred inward and suture fixed was completed. The appearance of breast was reshaped and the nipple-areola complex was elevated.ResultFrom Oct. 2008 to Jun. 2017, 15 patients were selected to this method for correcting moderate mastoptosis.All cases healed in good shape, no hematoma, infection, nipple necrosis and other serious complications.3 to 24 months follow-up after operation, two breast were symmetrical with nice shape and nipple sensory function properly. Average pre and postoperative left nipple-to-right nipple distance[（20.43±1.22） cm, （19.73±0.80） cm, P〈0.05], sternum notch-to-nipple distance[left （23.03±0.99） cm, （20.40±0.71） cm, P〈0.05; right （23.17±0.94） cm, （20.43±0.70） cm, P〈0.05], mammary areola diameter[left （4.97±0.55） cm, （4.63±0.68）cm, P〈0.05; right （4.97±0.50）cm, （4.57±0.50）cm, P〈0.05], lower pole of breast-to-inframammary fold distance [left （2.70±0.36） cm, （0.22±0.38） cm, P〈0.05; right （2.77±0.44） cm, （0.22±0.38） cm, P〈0.05], thoracic circumference at the nipple[（84.29±1.81） cm, （87.83±2.22） cm, P〈0.05]. The differences in the those data are statistically significant.ConclusionsUpward transfer of glandular flap provides a new approch for correcting moderate breast ptosis.

关 键 词：乳房下垂 乳腺  人 组织瓣 

分 类 号：R655.8[医药卫生—外科学]