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Objective@#To evaluate the effect of vertical incision with superomedial pedicle for the treatment of female asymmetric hypermastia.@*Methods@#The total of 31 patients with asymmetric breast hypertrophy were admitted from May 2012 to November 2018. All patients were female with an average age of 37.8 (28-55) years. Mammoplasty was performed by vertical incision with superomedial pedicle. According to the preoperative design, the epidermis of the pedicle, the excess skin and glandular tissue were removed. The superomedial pedicle was rotated upward and to be fixed on the major pectoralis fascia. After the fixation of the nipple areola, the incision was closed.@*Results@#The mean follow up was (8.4±3.0) months, with a range from 6 to 18 months.One patient was unsatisfied with scar hyperplasia. One patient had slight mastoptosis 6 months after operation and received favorable outcome after revision. The rest of 29 patients had satisfactory results.@*Conclusions@#For patients with asymmetric breast hypertrophy, the new location of nipples on both sides should be determined by the degree of mastoptosis and hypermastia. So that, symmetry breast as well as smaller breast can be obtained.
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Objective To study the method and effect of superomedial pedicled mammaplasty based on Würinger's horizontal septum.Methods During August 2014 to August 2015,25 cases of cromastia were treated with septum-based mammaplasties with a superomedial pedicled and vertical incision.Based on the preoperation design,the superomedial pedicle was deepithelialized with preservation of the dermis and the subdermal plexus.The pedicle was dissected as described,the excess tissue was removed with the prepectoral fascia preserved.After remodeling the shape of mammary gland,the incision was sutured.Results There was no hematoma,no fat liquefaction and no partial or complete NAC necrosis.The pre and postoperative NAC sensibilities were comparable in all the patients.The patients were followed up for 6 to 12 months,and all the patients were satisfied with the therapeutic effect and expressed acceptance to the scar.Conclusions The breast reduction based on wellvascularized septum and superomedial pedicle is safe with minor scar,even in large breasts.This technique demonstrates ease of pedicle shaping and breast remodeling.The satisfied effect could be obtained for patients with severe ptosis of breasts just after operations and in future.
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INTRODUÇÃO: Várias são as técnicas descritas para mamoplastia. Contudo nenhuma contempla a ressecção mamaria com a preservação areolar por meio de um pedículo obliquo múltiplo que envolve o sistema neurovascular superior medial e o sistema neurovascular inferior lateral; alem de preservar na glândula remanescente a unidade areolo-glandular original. Esta técnica mostra se, em tese, ideal para o tratamento da gigantomastia juvenil em nulipara, que ainda pode se beneficiar de uma mama mais funcional e preservada na sua inervação primaria e na sua capacidade de amamentação. Este retalho também pode usufruir de grande segurança contra isquemia em função de um largo pedículo vascular. OBJETIVO: Descrever a técnica de mamoplastia e relatar a serie inicial de casos operados nesta sistematização. MÉTODO: Em 40 mamas operadas descreve se a técnica do retalho fascioadenocutaneo areolado com mensuração da quantidade ressecada, sensibilidade pré- e pós- operatório e complicações. RESULTADOS: Todos os casos tiveram evolução satisfatória, sem necrose e com sensibilidade do complexo areolopapilar (CAP) preservada em mais de 70% das mamas operadas. CONCLUSÃO: O retalho fascioadenocutaneo areolado inervado mostrou-se seguro, funcional e versátil.
INTRODUCTION: Several mammoplasty techniques have been described. However, none involves breast resection with preservation of the areola through an oblique multiple pedicle that involves the medial superior neurovascular system and the lateroinferior neurovascular system, or preserves the original areola-glandular unit in the remaining gland. This technique is, in theory, ideal for the treatment of juvenile gigantomastia in nulliparous women who can still benefit from a more functional breast with its primary innervation and the patient's ability to breast-feed preserved. This flap can also present higher safety against ischemia owing to a broad vascular pedicle. OBJECTIVE: To describe this mammoplasty technique and report the initial series of operated cases. METHOD: The fascioadenocutaneous areolar flap technique is described in 40 operated breasts, including the quantity of the resected tissue, pre- and postsurgery sensitivity, and complications encountered. RESULTS: All cases had a satisfactory evolution, without necrosis and with preserved sensitivity of the nipple-areola complex in >70% of the breasts operated. CONCLUSION: The innervated fascioadenocutaneous areolar flap was safe, functional, and versatile.
Subject(s)
Humans , Female , Adolescent , Adult , Middle Aged , History, 21st Century , Surgical Flaps , Breast , Retrospective Studies , Mammaplasty , Mammary Glands, Human , Dissection , Surgical Wound , Surgical Flaps/surgery , Breast/surgery , Mammaplasty/methods , Mammary Glands, Human/surgery , Dissection/methods , Surgical Wound/surgery , Surgical Wound/therapyABSTRACT
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.
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Objective To explore a surgical procedure of reduction mammary plasty to assure the viability and sensory of the nipple-areolar complex (NAC) after transposition and to keep the lactiferous function partly. Methods Reduction was accomplished by using perforating vascular branches from the pectoralis major muscle and its fascia supplying the nipple and breast parenchyma instead of the subdermal plexus. The central vascular pedicle supplying the nipple-areola complex was preserved. And the sensory nerve of the NAC was not injured. The erection of the nipple could be observed in operation. Lactation was possible because of preservation of the lactiferous ducts. The technique had been used in 17 patients since 1996. Results The nipple-areola complex was safely transposed with great freedom, and the amount of resection was accurately adjusted for symmetry. No cases of nipple-areola complex sensory change occurred postoperatively in all 17 patients. Breast-feeding was possible at least in one patient after operation. Conclusion This method is ideal for the patients, which keeps the viability and sensory of the nipple-areolar complex and the function of lactation. In another case, the amount of resection is easily adjusted for symmetry.