Isken Tonguç, Sen Cenk, Onyedi Murat, Izmirli Hakki
Department of Plastic and Reconstructive Surgery, Kocaeli University Faculty of Medicine, Kocaeli, Turkey.
Aesthetic Plast Surg. 2008 Jul;32(4):675-80. doi: 10.1007/s00266-008-9185-z. Epub 2008 May 28.
Free-nipple-graft reduction mammaplasty is the procedure of choice in patients with massive breast hypertrophy. Breasts that have undergone free-nipple-graft reduction mammaplasty usually cannot maintain projection. Many modifications of free-nipple-graft reduction mammaplasty have been described to treatment this problem. We describe our modification of the free-nipple-graft reduction mammaplasty.
The technique includes two key points: The first is the fold of the midportions of the breast. The second is suturing the midportion of the breast to the fascia of the pectoral muscle. The fold increases breast projection and the suturing helps to obtain long-lasting breast projection.
A total of 16 patients underwent free-nipple-graft reduction with the modified technique between 2003 and 2008. Mean follow-up was 21 months (range = 3-60 months). An average of 2016 g of tissue per breast was excised (range = 1250-2700 g per breast). An average of 4031 g of tissue per patient was excised. All patients had long-lasting, pronounced breast mound projection. Satisfactory breast projection was maintained. No "bottoming out" was seen. The level of satisfaction felt by all patients was very high.
Long-term projection can be maintained by suturing the half-trianges to each other and to the fascia of the pectoral muscle. One more useful alternative technique for increasing projection in free-nipple-graft reduction has been added with the technique presented.
游离乳头移植缩乳术是巨乳症患者的首选手术方法。接受游离乳头移植缩乳术的乳房通常无法维持挺拔形态。为解决这一问题，人们已描述了多种游离乳头移植缩乳术的改良方法。我们在此描述我们对游离乳头移植缩乳术的改良方法。
该技术包括两个关键点：一是乳房中部的褶皱；二是将乳房中部缝合至胸肌筋膜。褶皱可增加乳房挺拔度，缝合有助于获得持久的乳房挺拔效果。
2003年至2008年间，共有16例患者采用改良技术接受了游离乳头移植缩乳术。平均随访时间为21个月（范围 = 3 - 60个月）。每侧乳房平均切除组织2016克（范围 = 每侧乳房1250 - 2700克）。每位患者平均切除组织4031克。所有患者均获得了持久、明显的乳房隆起挺拔效果。乳房挺拔度令人满意，未见“下垂”现象。所有患者的满意度都非常高。
通过将半三角相互缝合并缝合至胸肌筋膜可维持长期挺拔效果。本文所介绍的技术为增加游离乳头移植缩乳术中乳房挺拔度提供了又一种有用的替代技术。
