Colwell Amy S, Breuing Karl H
Division of Plastic Surgery, Department of Surgery, Massachusetts General Hospital, Boston, MA, USA.
Ann Plast Surg. 2008 Aug;61(2):138-42. doi: 10.1097/SAP.0b013e31815bfe7c.
Mastopexy and reduction mammaplasty reshape breast parenchyma and restore youthful contour in women with ptotic breasts. However, recurrent ptosis and breast base widening are common. We have been using internal autologous or cadaveric (AlloDerm) dermal slings to circumferentially support and shape the breasts for symmetry or rejuvenation. Ten patients underwent unilateral mastopexy (3), unilateral reduction-mastopexy (1), bilateral mastopexy (5), or bilateral reduction-mastopexy (1) with an internal dermal sling to correct breast reconstruction asymmetry (2), congenital asymmetry (2), or acquired ptosis (6). Three of 6 patients acquired breast ptosis after massive weight loss. Autologous dermis was used in 5 patients, and 5 patients were reconstructed with AlloDerm. Patients have maintained projection and breast base width after 6 months to 3 years. In conclusion, internal dermal slings improve shape, breast projection, and base width in select patients undergoing mastopexy. An algorithm based on quantity and quality of native skin is provided.
乳房上提术和乳房缩小整形术可重塑乳房实质，并使乳房下垂的女性恢复年轻的外形。然而，复发性乳房下垂和乳房基部增宽很常见。我们一直在使用自体或尸体（同种异体真皮）真皮吊带在乳房周围进行支撑和塑形，以实现乳房对称或年轻化。10例患者接受了单侧乳房上提术（3例）、单侧乳房缩小上提术（1例）、双侧乳房上提术（5例）或双侧乳房缩小上提术（1例），术中使用内部真皮吊带以纠正乳房重建不对称（2例）、先天性不对称（2例）或后天性乳房下垂（6例）。6例患者中有3例在大量体重减轻后出现乳房下垂。5例患者使用了自体真皮，5例患者用同种异体真皮进行了重建。患者在术后6个月至3年保持了乳房的突度和基部宽度。总之，内部真皮吊带可改善接受乳房上提术的特定患者的乳房外形、突度和基部宽度。本文提供了一种基于天然皮肤数量和质量的算法。
