Chalekson Charles P, Neumeister Michael W, Zook Elvin G, Russell Robert C
Institute of Plastic Surgery, Southern Illinois University School of Medicine, Springfield, IL 62794-9653, USA.
Plast Reconstr Surg. 2002 Jul;110(1):71-9; discussion 80-1. doi: 10.1097/00006534-200207000-00013.
The benefits of reduction mammaplasty have been well documented in previous literature. Anticipating and correcting for pseudoptosis (bottoming-out), however, can impair the cosmetic outcome as the inferior skin envelope stretches and lengthens over time. We present long-term results on patients using the modified Robertson technique for reduction mammaplasty, which appears to have significant benefit in helping to prevent bottoming-out. Surveys were sent to patients undergoing reduction mammaplasty surgery with this technique from 1987 to 1997. Patients were queried regarding preoperative and postoperative symptoms, satisfaction, and outcome related to their surgery and were also offered free follow-up examinations. The patients who returned for follow-up were then evaluated by the attending surgeons for evaluation of scarring, nipple position, ptosis, pseudoptosis, shape, and overall appearance. Reduced breasts were also compared with cosmetically optimal breasts to compare for measured levels of pseudoptosis using our defined visual inferior pole ratio measurements. Average reduction size was 910 g and follow-up was 4.7 years from the time of surgery. There was significant improvement demonstrated in all areas questioned, with the greatest relief shown in back and shoulder pain, shoulder grooving, and difficulty fitting clothing. There was also demonstrated to be significantly less use of medical modalities postoperatively and significant increases in activity levels. Satisfaction for size, shape, symmetry, and overall results was 85, 94, 98, and 94 percent, respectively. Evaluations for pseudoptosis by the attending surgeons were rated good or excellent in 95 percent of patients. Measurements of the visual inferior pole ratio for pseudoptosis also demonstrated no significant differences when compared with aesthetically optimal breasts. The modified Robertson reduction mammaplasty is a reliable technique that can be used for both small and large reductions, giving both reliable and consistent results. This technique significantly improves symptoms, as do other reduction techniques, but has the added advantage of helping to avoid pseudoptosis postoperatively.
缩乳术的益处已在以往文献中得到充分记载。然而，随着时间的推移，随着乳房下皱襞皮肤包膜伸展和拉长，预期并纠正假性下垂（乳房下极下垂）会损害美容效果。我们展示了采用改良罗伯逊技术进行缩乳术患者的长期结果，该技术在帮助预防乳房下极下垂方面似乎具有显著益处。我们向1987年至1997年采用该技术接受缩乳术的患者发送了调查问卷。询问患者术前和术后的症状、满意度以及与手术相关的结果，还为他们提供免费的随访检查。然后，主刀医生对前来随访的患者进行评估，以评估瘢痕、乳头位置、下垂、假性下垂、形状和整体外观。还将缩小后的乳房与美容效果最佳的乳房进行比较，使用我们定义的视觉下极比率测量方法来比较假性下垂的测量水平。平均缩乳量为910克，自手术时起随访4.7年。在所有被询问的方面均显示出显著改善，背部和肩部疼痛、肩部压痕以及穿着衣服困难等方面的缓解最为明显。术后使用医疗手段的情况也显著减少，活动水平显著提高。对尺寸、形状、对称性和整体效果的满意度分别为85%、94%、98%和94%。主刀医生对假性下垂的评估中，95%的患者被评为良好或优秀。与美容效果最佳的乳房相比，假性下垂的视觉下极比率测量结果也无显著差异。改良罗伯逊缩乳术是一种可靠的技术，可用于大小不同程度的缩乳，能给出可靠且一致的结果。该技术与其他缩乳技术一样，能显著改善症状，但还有助于避免术后出现假性下垂这一额外优势。
