改良双环法乳房下垂矫正术(1)
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[摘要]目的：介绍改良双环法行乳房悬吊术的方法和经验。方法：采用传统的双环法环乳晕切口，切除双环间表皮，在皮肤与上半乳腺的腺体表面之间剥离，去除上半腺体后松弛的浅筋膜深层，上提腺体至正常位置并固定于深筋膜，同时进行腺体的适当折叠塑形或置入乳房假体增加丰满程度。结果：共行轻、中度下垂28例(4例为单侧下垂)，其中悬吊加假体隆乳9例；腺体瓣交叉缝合悬吊塑形19例。术后乳房外形改善满意，乳头、乳晕感觉良好，效果持久。结论：本手术方法安全易行，组织损伤小，瘢痕不明显，是矫治轻、中度乳房下垂的一种比较理想的方法。
[关键词]乳房下垂；双环法乳房悬吊术；乳腺组织瓣
[中图分类号]R655.8 [文献标识码]A [文章编号]1008-6455(2012)01-0012-02
Modif ication of periareolar mastopexy
WANG Qi, XIE Qun, LIU Dan-dan
(Department of Plastic Surgery,The Center Hospital of Xiangyang,Xiangyang 441021,Hubei,China)
Abstract: Objective To introduce the method and experience of modified periareolar mastopexy. Methods Through a periareolar incision, The epidermal tissue was incised between the out side and the inside ring. The upper quadrant of the breast was just peeled off.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,rotated toward each other and moulded. Implant augmentation was simultaneously employed to enhance the projection,if necessary. Results A total of 28 cases of mild to moderate breast ptosis was treated with this technique, including 9 cases of mastopexy with implant augmentation, 19 cases of mammary glandular flap rotated each other. Satisfactory results were achieved with pretty breast shape and inconspicuous periaerolar scar. Conclusion This method is simple,safe and effective.It is an optimal choice for breast ptosis in mild to moderate degree.
Key words:breast ptosis; periareolar mastopexy; mammary glandular flap
乳房下垂是女性中比较常见的乳房畸形,尤其多见于某些生育及哺乳后的女性,由于乳房组织松弛而引起乳房整体下垂,不仅影响形体的曲线美,而且乳房的下皱襞处容易发生湿疹、疥疮等皮肤疾病，造成了患者生理及心理上的痛苦,因此需要手术治疗。笔者自2005年3月以来,应用改良双环法进行乳房轻、中度下垂矫正手术28例,取得了满意的效果,现报道如下。
1 临床资料
本组共28例患者(52侧乳房) ,年龄23～48 岁,平均年龄36岁，2例未婚未育。乳房轻度下垂者12例，中度下垂者16例。9例乳房下垂伴小乳症，11例乳房下垂伴乳房肥大。
2 手术方法
2.1 术前设计：患者取坐位或立位, 以乳头为中心，乳晕直径为3.5～4.0cm画圆，为内环线。设计新乳头位置于锁骨中线与第 4 肋间水平交界处，乳头距胸骨切迹中点的距离为19～21cm。锁骨中线上新乳头上方2 cm处为点A,分别于第4肋水平胸骨旁线外侧、腋前线内侧7～9cm处标记B、D，于乳房下皱襞上方5～6cm处标记C点。将其弧形连接，则为外环线。同时，标出外环至乳房基底部之间的皮下剥离范围。
2.2 手术操作
2.2.1 麻醉方法：采用全身麻醉或局部浸润麻醉。
2.2.2 剥离：将设计内、外两环间的表皮去除。然后在真皮的上边缘线切开至腺体表面，沿腺体表面向上剥离至乳腺上极 ......
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