垂直切口内侧蒂式乳房缩小整形术的疗效及并发症分析  

Analysis of Curative Effect and Complications of Medial Pedicle Reduction Mammaplasty with Vertical Incision

作　　者：唐红梅 TANG Hongmei(Department of Plastic Surgery,the Second Affi liated Hospital of Soochow University,Suzhou 215008,Jiangsu,China)

机构地区：[1]苏州大学附属第二医院整形美容外科,江苏苏州215008

出　　处：《中国美容医学》2022年第4期43-46,共4页Chinese Journal of Aesthetic Medicine

摘　　要：目的:探究垂直切口内侧蒂式乳房缩小整形术的治疗效果,分析术后并发症发生情况。方法:2018年1月-2021年3月对92例乳房肥大患者采取垂直切口内侧蒂式乳房缩小术进行治疗,根据术前设计,去除表皮,保留真皮、腺体组织蒂,切除画线区域内,即乳房下极部分皮肤、腺体组织,内侧带真皮腺体蒂向上旋转,固定于新位置;乳房下部腺体“U”形切除,然后向内上方缝合固定于胸壁,分层缝合。结果:本组92例(184侧)患者,术中切除腺体重量376~830 g,术后切口均一期愈合,患者主观症状均完全消失,乳头乳晕血运及感觉良好,乳房位置自然、外形丰满;温哥华瘢痕评分0~6分,平均(3.67±1.02)分;患者满意度为96.74%(89/92)。术后,患者左右侧锁乳线、左右侧胸乳线、过乳头胸围和乳晕直径等均较术前有明显改善,生活质量水平较术前明显提高,差异均有统计学意义(P<0.05)。术后随访6~12个月,3例患者手术切口感染,经常规治疗后恢复;1例右侧乳晕切口上缘瘢痕增生,经瘢痕切除缝合;3例脂肪液化,经清创引流、局部换药后自行愈合。结论:垂直切口内侧蒂式乳房缩小整形术操作安全,术后切口瘢痕较小,能明显修复患者乳头乳晕位移,改善患者生活质量,且术后并发症较少,具有良好的治疗效果。Objective To explore the therapeutic effect of medial pedicle reduction mammaplasty with vertical incision, and analyze postoperative complications. Methods This study included 92 patients with breast hypertrophy who were treated with medial pedicle reduction mammaplasty with vertical incision between January 2018 and March 2021. According to the preoperative design, the areola epidermis of medial nipple was removed, some glandular tissue pedicle was retained, and the dermal pedicle of medial gland was rotated upwards and fixed in a new position after some skin and glandular tissues of lower breast were removed. The lower breast gland was removed in a V shape, and then sutured inward and upward to fix it to the chest wall with suture in layers. Results In this group of 92 patients(184 sides), the weight of the gland removed during the operation was 376-830 g, the incision healed in one stage, the subjective symptoms of the patients disappeared completely, the nipple areola blood supply and feeling were good, the breast position was natural and the shape was plump. The Vancouver scar score was 0-6, with an average of(3.67±1.02). The patient satisfaction was 96.74%(89/92). After operation, the patients’ left and right breast locking line, left and right breast milk line, nipple chest circumference and areola diameter were significantly improved compared with those before operation, and the quality of life was significantly improved compared with those before operation, the differences were statistically significant(P<0.05). The patients were followed up for 6-12 months. 3 cases of surgical incision infection recovered after regular treatment. One case had scar hyperplasia on the upper edge of the right areola incision, which was resected and sutured by scar. 3 cases of fat liquefaction healed by debridement and drainage and local dressing change. Conclusion Medial pedicle reduction mammaplasty with vertical incision is safe to operate, with small scar.It can significantly repair nipple and areola displacement, a

关 键 词：乳房肥大 乳房缩小整形术 垂直切口 内侧蒂式 疗效 并发症 

分 类 号：R655.8[医药卫生—外科学]