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Objective:To investigate the feasibility of superior polar gland flap resection combined with biplanar augmentation mammoplasty through the root of the nipple to correct pseudoptosis/mild breast ptosis.Methods:From January 2019 to January 2021, 20 patients (40 breasts) with pseudoptosis/mild breast ptosis underwent augmentation mammoplasty with superior polar gland flap through the root of the nipple and microvilli anatomical silica gel prosthesis.Results:No postoperative complications such as hematoma infection, capsular contracture and abnormal sensation of the nipple and areola were found in 20 patients. During the follow-up of 3 to 18 months, the patients' breasts were plump and straight, the appearance was good, and the prolapse was basically corrected. Postoperative satisfaction was achieved in 20 cases (95%), and the satisfaction of incision scar was 100%.Conclusions:The comprehensive surgery restores the normal anatomical suspension system of the breast, achieves a long-term mechanical stable balance among prosthesis, muscle, breast gland and skin, and receives high satisfaction with breast shape after operation.
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Objective:To explore the value of tailor-tack technology in vertical mastopexy and to evaluate the clinical effect of vertical mastopexy in correcting breast ptosis.Methods:From April 2010 to August 2020, 47 women aged 18 to 51 years took part in the study, and the tailor-tack technology was used to ensure the amount of redundant skin removal. The patients＇ degree of ptosis was moderate or severe, and the average age was 38.2 years.Results:All the cases had their drainage tube removed 2-3 days after surgery and the wound stitches removed 12-14 days after surgery. All patients had tight and full breasts after surgery. Patients were satisfied with their new breast shapes. After surgery, no patients showed early complications such as necrosis of nipple-areola complex or skin, poor wound healing or abnormal nipple sensation. Follow-up lasted for 6 months to 5 years, and there were no long-term complications such as recurrence of breast ptosis, poor nipple shape, scar flatten and enlargement.Conclusions:Tailor-Tack technology is useful in vertical mastopexy. It can be helpful to evaluate the amount of skin removal, effectively avoiding the situation of insufficient or excessive skin removal. Therefore, this is a desirable clinical skill in mastopexy.
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Objective To introduce a modified vertical scar method (Hall-Findlay method) and its improved technique.Methods From May 2009 to May 2018,128 cases of female mammoplasty were completed in the Department of Plastic Surgery,Nanfang Hospital of Southern Medical University,aged 22 to 49 years,with an average of 38.3 years.56 cases underwent breast reduction surgery and 72 cases underwent breast suspension surgery.The surgical incision was designed according to the Hall Findlay method.Firstly,the inner skin of the design line was shaved to form a leather cap,the breast tissue was removed,the upper or inner pedicle was preserved,and the Würinger's horizontal septum structure was arranged to ensure the blood supply and innervation of the nipple areolar complex.The partially enlarged basal mammary gland tissue was removed,and the remaining mammary tissue was fixed upward at the second rib level.The redundant skin of the breast was fully reduced and sutured.For patients with obvious breast hypertrophy,intraoperative combined aspiration of fat was used,mainly to reduce the subcutaneous fat of the lateral and lateral chest of the breast gland.Results A total of 128 cases of breast disease and simple breast sagging were treated with this method.Only 1 case showed nipple areolar complex ischemia in the early postoperative period.After 3 months to 6 months follow-up,the breast shape was good and the satisfactory rate was over 95％.Conclusions This procedure is modified from the Lejour method of vertical scar mammoplasty.The full thickness of the pedicle is preserved compared with the Lejour method.The anatomical structure of the horizontal septum is preserved during the operation to reduce the postoperative nipple-areolar complex dysfunction and poor blood supply.The probability of occurrence and the long-term effect are good,the shape of the breast is straight,and it is worth promoting.
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Background: The health and good esthetic conditions of the breast are important indicators of women’s life quality. One factor that negatively affects this quality is the breast ptosis, associated with the sagging of the mammary glands due to tissue stretching and the loss of tissue and skin elasticity. New tools and methods able to improve the shape and beautiful contour of the breast are highly desirable.Methods: We investigated how the disposable bra pads by BAE International Inc., having the lymphatic drainage effect for the breast, influenced the female breast state. We applied two methods, the ultrasound elasticity imaging and the pattern recognition of the nipples position, to monitor the breast state dynamics in two groups of females, the study and control ones.Results: Preliminary results showed that both the breast elasticity and the pattern of nipple positions improved for females wearing the bra pads as compared to females wearing regular bras without pads (P<0.05 for the difference between the two groups of females).Conclusions: Overall, the bra pads by BAE can be considered as an effective tool encouraging metabolism by improving the flow of blood circulation and lymph in the breast.
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Objective To evaluate the clinical effect of circumvertical mastopexy with internal shaping using inferior dermal-glandular flap for correction of breast ptosis.Methods From April 2010 to November 2017,33 cases of breast ptosis were treated in our department.The patients required nipple elevation of 3-6 cm and had unpleasing result after circumareolar mastopexy were treated with the technique of circumvertical lift with breast suspension and internal shaping with inferior dermal-glandular flap which pedicle was on the inframammary crease and tack technique for removing excessive skin precisely.Results 33 cases had their drainage tubes removed at the 2～3 days and suture removed at the 12～14 days postoperatively.All had primary healing of incision and no complications such as necrosis of NAC and dehiscence of incision occurred.Elastic bra was asked to wear for three to six months and then stable shape was achieved.Follow-up lasted for 6-60 months.All cases were satisfied with their new breast shape.Conclusions Circumvertical mastopexy with internal shaping using inferior dermal-glandular flap is a simple and effective method with relatively short scar and good shape for correction of the medium grade breast ptosis.
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Objective To evaluate an improved technique of vertical mammaplasty with purse string suture for correction of breast ptosis and its clinical application.Methods The adjustable markings of vertical mammaplasty was improved with an upper pedicle for the areola,and breast reduction was adapted with the lower part.The breast tissue was lifted and fixed on the second rib level to reshape the breast,which did not rely on the skin,with purse string suture for the lower half of vertical incision.32 patients with breast ptosis had been operated from May 2009 to February 2014.Results 32 cases were treated with vertical mammaplasty with short scar.The shape of the breasts was strengthen,without obvious scar,and follow-up results of patients were satisfied.Conclusions The vertical mammaplasty with short scar design is simple,operation is convenient,breast shape is plump,and postoperative long-term effect is great.This procedure can be used as one of the feasible operation for breast ptosis correction.
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Objective To analyze the clinical outcomes of using double-circle incision combined with the dermal bra technique for the correction of simple breast ptosis.Methods From March 2010 to December 2014,88 patients underwent breast ptosis correction using the technique,among which 52 cases were classified into mild ptosis,27 moderate ptosis,and 9 severe ptosis.According to the extent of ptosis,varying size of the dermal bra were designed,and the mammary glandular flap was rotated,suspended and fixed onto the pectoralis fascia.For patients with insufficient size of the dermal bra,the polypropylene mesh was used to assist glandular suspension and fixation.Follow-up duration was between 3 to 24 months,and the surgical effect was evaluated from the following aspects:wound healing,breast sensory,shape,and texture,etc.Results The 4 cases (4.5％) had hematoma,and 3 cases (3.4％) suffered from poor wound healing.No case of fat liquefaction,necrosis of the nipple and areola complex,sensory disorder of NAC,or secondary ptosis was examined.Mammary contour was slightly rigid in the early postoperative period but gradually becoming natural with soft texture 3 months postoperatively.Conclusions Double-circle incision combined with the dermal technique is worth spreading in the clinical practice of breast ptosis correction for its satisfactory outcomes and low incidence of complications.
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Introdução: Insatisfação dos pacientes com resultado de mamoplastia redutora pode ser identificado em alguns casos, especialmente quando apresentam ptose acompanhada de flacidez excessive, estrias, e ainda, componente mamário mais gorduroso que glandular. Nesses tipos de pacientes, é muito difícil conseguir bons resultados por longo período. Implantes mamários de pequeno volume, podem ser colocados no mesmo tempo da mamoplastia redutora com o objetivo de se obter melhor forma, contorno e projeção das mamas, com maior satisfação a longo prazo. Método: No período de 1997 a 2012, duzentos e sessenta e quatro pacientes com idade entre 27e 55 anos (idade média de 38), foram submetidas à mamoplastia redutora com imediata colocação de implante mamário. Resultados: Foram obtidos resultados satisfatórios, com adequado preenchimento do pólo superior, mamas firmes e reduzida estatística de ptose pós-operatória. Foram identificados dois casos de carcinoma in sito, como achados no anátomo-patológico. Conclusão: Mastoplastia redutora associada a implantes de silicone é um procedimento seguro para casos selecionados.
INTRODUCTION: Patient dissatisfaction with reduction mammoplasty outcomes can occur, especially in cases of ptosis accompanied by excessive flaccidity, striations, and a higher fat than glandular content. In such cases, achieving long-lasting results is very difficult. Small-volume breast implants can be placed during the reduction mammoplasty with the purpose of obtaining better breast shape, contour, and projection as well as greater long-term satisfaction. METHOD: Between 1997 and 2012, 264 patients aged 27-55 years (mean, 38) underwent reduction mammoplasty with immediate placement of breast implants. RESULTS: Satisfactory results were obtained, with adequate filling of the upper pole, increased breast firmness, and statistical reduction in postoperative ptosis. Two cases of carcinoma in situ were identified in the pathological exam. CONCLUSION: Reduction mastoplasty associated with silicone implants is safe for selected cases.
Subject(s)
Humans , Female , Adult , Middle Aged , History, 21st Century , Postoperative Complications , Silicones , Breast , Breast Neoplasms , Mammaplasty , Breast Implants , Plastic Surgery Procedures , Mammary Glands, Human , Esthetics , Hypertrophy , Postoperative Complications/surgery , Postoperative Complications/pathology , Silicones/therapeutic use , Silicones/chemistry , Breast/surgery , Breast/injuries , Breast Neoplasms/surgery , Mammaplasty/adverse effects , Mammaplasty/methods , Breast Implants/adverse effects , Breast Implants/standards , Plastic Surgery Procedures/methods , Mammary Glands, Human/surgery , Mammary Glands, Human/injuries , Hypertrophy/surgery , Hypertrophy/complicationsABSTRACT
Objective To seek an effective surgical procedure to treat patients with the varying degrees of breast ptosis and micromastia.Methods Patients were classified into Ⅰ-Ⅳ degrees based on different breast ptosis,and treated by different methods.Degree Ⅰ was treated with implanting prosthesis to the post-pectoralis major space; degree Ⅱ patients were repaired with avulsion of deeper mammary gland and pectoralis major and hanging fixed breast tissue,based on the degree Ⅰ procedure; degree Ⅲ was fixed with breast tissue flap,excised redundant epidermis by the method of double-rings and the complex of nipple and areola was shifted,based on the degree Ⅱ procedure; degree Ⅳ was repaired with implanting prosthesis and the method of lines to hanging fixed breast.Results In 116 cases of this study,there were no hematoma,infection and nipple and areola necrosis by the combined strategies.The follow-up period after the surgery was 6-31 months (mean 13.3 months).All cases had voluptuous and upright breasts,rectified breast ptosis,with the normal sense of nipple and areola.Conclusions For breast ptosis and hypoplasia,the combined strategies have better clinical therapeutic effects.
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Objective Implanting surgical meshes to support breast in periareoler mammaplasty shows an excellent prospect.But shrinking of the mesh and the adhesion formation affected the postoperative shape and palpation of the breast.The aim of this study was to compare biocompatible properties of four different polypropylene meshes (Prolene(R) ; Vypro Ⅱ(R) ; Premilene Mesh (R) and Premilene Mesh LP(R)) and to discuss the inclusion criteria of meshes in this technique.Methods The study was carried out in pigs.Four different polypropylene meshes were implanted subcutaneously in belly.90 days after implantation the mesh samples were explanted,and complications,foreign-body reaction,collagen fiber and elastic fiber formation were observed,as well as ultrastructures for the biocompatible properties.Results The biocompatible properties of each mesh were different.The foreign-body reactions determined the biocompatible properties,and affected the postoperative shape greatly.Conclusions Premilene Mesh LP o as a newer low-weight polypropylene mesh,has superior properties to the others.
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Objective To introduce and evaluate an improved technique of vertical mammaplasty for correction of severe breast ptosis. Methods Vertical mammaplasty that was first reported by Ma-deleine Lejour in Brussels is a technique that uses adjustable markings, an upper pedicle for the areola, and a central breast reduction with lower skin undermining. To shorten vertical scar, it was important to locate new nipple position and move up new inframammary fold. The shape of the breast was crea-ted by suturing the gland and did not rely on the skin. No scar was produced in submammary fold. Re-sults 36 cases were treated with vertical mammaplasty in our department since August 1999. The shape of the new breast was satisfactory in all patients after 3-24 months following-up. Areora necro-sis was not found in all the cases. Conclusion The vertical mammaplasty is an optical technique for correction of severe breast ptosis, Stable results are produced because the gland is strongly sutured.
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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.
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Objective To introduce an improved technique of periareolar incision mammoplasty using gland flap suspending and contour line circum-contraction suturing. Methods Through the periareolar incision, dissection was conducted between the subcutaneous tissue and the glandular tissue to detach the skin flap tent from the gland cone. A vertical glandular flap was formed in the upper portion to suspend the gland, with the gland tissue partially excised medial and lateral to the vertical glandular flap. Continuous contour line circum-contraction suturing was made for 2～3 rounds step by step from the cone bottom to the plateau, i.e. the nipple areola level. The suturing proceeded alternately from the flap tent to the glandular cone. Finally, the skin was sutured along the areolar incision. Results Sixteen breasts of eight patients were operated on using the present technique, including 10 cases of macromastia and 6 of breast ptosis. Satisfactory results were achieved with pretty breast shape and inconspicuous periareolar scar. Conclusion The contour line circum-contraction suturing periareolar incision mammoplasty is an optimal choice for moderate macromastia and breast ptosis.