垂直切口内上蒂法辅助吸脂技术在乳房缩小术中的应用  

Application of liposuction technique assisted superomedial pedicle with vertical incision in reduction mammaplasty

作　　者：杨智斌 李发成[1] 韩雪峰[1] 蔡磊[1] 尹博 YANG Zhibin;LI Facheng;HAN Xuefeng;CAI Lei;YIN Bo(Department of Body Contouring and Liposuction Center,Plastic Surgery Hospital,Chinese Academy of Medical Sciences,Peking Union Medical College,Beijing,100144,P.R.China)

机构地区：[1]北京协和医学院中国医学科学院整形外科医院形体雕塑与吸脂中心,北京100144

出　　处：《中国修复重建外科杂志》2020年第6期775-780,共6页Chinese Journal of Reparative and Reconstructive Surgery

摘　　要：目的探讨采用垂直切口内上蒂法辅助吸脂技术行乳房缩小术的疗效。方法 2014年3月-2019年3月,采用垂直切口内上蒂法辅助吸脂技术对65例(127侧)乳房肥大伴下垂患者行乳房缩小术。患者年龄21~58岁,平均42.2岁。体质量指数18.8~26.5 kg/m2,平均21.3 kg/m2。其中,62例双侧手术,3例单侧手术。乳房下垂程度根据Regnault分度标准,Ⅱ度73侧、Ⅲ度54侧。结果术中单侧乳房组织切除量228~932 g,平均432 g;乳头上移距离4.5~9.5 cm,平均6.5 cm;吸脂量50~380 mL,平均148 mL。术后2侧(1.58%)乳房内血肿形成,4侧(3.15%)乳房垂直切口发生轻度裂开,1侧(0.79%)乳头乳晕表皮层坏死。患者均获随访,随访时间6个月~5年,平均18个月。随访期内乳房无明显下垂,乳晕无明显扩大,无1例患者再次行瘢痕切除术。末次随访时,医生对矫形后乳房评价:乳房外形及对称性满意52例、较满意10例、不满意3例;乳头位置及乳晕直径满意51例、较满意11例、不满意3例;切口瘢痕明显25例,不明显40例。患者自评满意度:乳房外形满意48例、较满意12例、不满意5例;切口瘢痕满意40例、较满意17例、不满意8例;总体评价满意52例、较满意7例、不满意6例。结论垂直切口内上蒂法辅助吸脂技术安全、可靠,采用该技术行乳房缩小术可获得满意疗效。Objective To explore the effectiveness of liposuction technique assisted superomedial pedicle with a vertical incision in reduction mammaplasty.Methods Between March 2014 and March 2019,65 patients(127 sides)with breast hypertrophy had undergone breast reduction by using liposuction technique assisted superomedial pedicle with a vertical incision.The patients were 21 to 58 years old,with an average of 42.2 years.Body mass index ranged from 18.8 to 26.5 kg/m2,with an average of 21.3 kg/m2.Among them,62 cases were bilateral operations and 3 cases were unilateral operation.The degree of mastoptosis was rated as degreeⅡin 73 sides and degreeⅢin 54 sides according to the Regnault criteria.Results The unilateral breast removed 432 g on average(range,228-932 g);the distance of nipple upward was 4.5-9.5 cm(mean,6.5 cm);the volume of unilateral liposuction was 50-380 mL(mean,148 mL).There were 2 sides(1.58%)of unilateral intramammary hematomas after operation,4 sides(3.15%)of bilateral breast vertical incisions slightly split,and 1 side(0.79%)of the nipple-areola epidermis necrosis.All patients were followed up 6 months to 5 years,with an average of 18 months.During the follow-up,there was no evident re-dropping of the breast and no enlargement of the areola.No patient underwent scar excision.At last follow-up,the effectiveness was evaluated by the surgeons.There were 52 cases with very satisfactory,10 cases with satisfactory,and 3 cases with unsatisfactory for the breast shape and symmetry.There were 51 cases with very satisfactory,11 cases with satisfactory,and 3 cases with unsatisfactory for the nipple position and areola diameter.The incision scar was obvious in 25 cases and was not obvious in 40 cases.The results of self-assessment showed very satisfactory for the breast shape in 48 cases,satisfactory in 12 cases,and unsatisfactory in 5 cases;very satisfactory for the incision scar in 40 cases,satisfactory in 17 cases,and unsatisfactory in 8 cases.Overall evaluation of the patient was very satisfactory in 52 case

关 键 词：乳房缩小术 乳房肥大 乳房下垂 内上蒂 吸脂 

分 类 号：R655.8[医药卫生—外科学]