Clough K B, Kroll S S, Audretsch W
Department of Senology at the Institut Curie, Paris, France.
Plast Reconstr Surg. 1999 Aug;104(2):409-20. doi: 10.1097/00006534-199908000-00014.
In many cases, breast deformity caused by partial mastectomy can be reduced or corrected by plastic surgery. Partial breast reconstruction is best performed immediately after the partial mastectomy using an approach determined by the size of the breast and the defect. Small defects in large breasts usually need no reconstruction. For larger defects in large breasts, breast reshaping (similar to reduction mammaplasty) combined with a contralateral breast reduction is usually the best option. For medium-sized or smaller breasts with small to moderate-sized defects, local flaps from the subaxillary region are very useful. If the defect is too large for correction with local tissue, a latissimus dorsi myocutaneous flap is usually the best choice. Using these techniques, patients can achieve aesthetically better outcomes from breast-conservation therapy, even when larger tumors are being treated or when wider margins are taken to reduce the risk of tumor recurrence. By working together with an oncologic surgeon and facilitating the removal of larger tumors, the plastic surgeon can widen the indications for both breast-conservation therapy and breast reconstruction at the same time.
在许多情况下，部分乳房切除术导致的乳房畸形可通过整形手术减轻或矫正。部分乳房重建最好在部分乳房切除术后立即进行，采用根据乳房大小和缺损情况确定的方法。大乳房中的小缺损通常无需重建。对于大乳房中的较大缺损，乳房重塑（类似于缩乳术）联合对侧乳房缩小通常是最佳选择。对于有小至中等大小缺损的中号或更小乳房，腋窝下区域的局部皮瓣非常有用。如果缺损过大，无法用局部组织矫正，背阔肌肌皮瓣通常是最佳选择。使用这些技术，即使在治疗较大肿瘤或切除更宽切缘以降低肿瘤复发风险时，患者也能从保乳治疗中获得更好的美学效果。通过与肿瘤外科医生合作并协助切除更大的肿瘤，整形外科医生可以同时扩大保乳治疗和乳房重建的适应症。
