Carvajal Jenny, Echeverry Alberto
Aesthet Surg J. 2005 Mar-Apr;25(2):117-25. doi: 10.1016/j.asj.2005.02.005.
The use of the periareolar incision in breast augmentation procedures results in inconspicuous scarring. However, this approach is problematic when treating a patient with a small nipple-areolar complex (NAC) diameter.
We describe a simple procedure for breast augmentation in patients with a small NAC diameter that uses an alternative periareolar approach to produce a scar similar to that resulting from the conventional periareolar incision.
The conventional periareolar approach requires an areolar diameter of at least 3 cm for breast augmentation. We utilized geometric calculations to obtain values of perimeters and areas of hemi-ellipses for circles with diameters between 2 and 2.9 cm that are similar to the values calculated for a circle 3 cm in diameter. We applied the findings to our surgical technique. A crescent moon-shaped incision was made using a zigzag pattern on the hemiareolar inferior border, and the epidermis was removed from this area. The dissection was made through the mammary parenchyma and by way of the external arch. The inframammary crease was lowered enough so that the implant would be centered under the nipple when the incision was closed. A silicone gel-filled implant was inserted, and the lower edge of the incision was overlapped onto the deepithelialized upper flap, allowing the edges of the wound to join and seal in layers without requiring a purse-string support.
Between June 2002 and June 2004, we used this technique in 10 patients with areolar diameters ranging from 2.2 to 2.8 cm who requested primary breast augmentation with either cohesive gel or liquid silicone gel-filled implants. The resulting scar was satisfactory in color and quality for 8 patients; 2 patients had lateral widening of the scar. There was a slight change in the areolar diameter compared to the original diameter in all patients, but there were no deformities.
This simple procedure is an effective alternative technique for breast augmentation surgery in patients with a small NAC diameter.
在隆胸手术中采用乳晕周围切口可使瘢痕不明显。然而，对于乳头乳晕复合体（NAC）直径较小的患者，这种方法存在问题。
我们描述一种针对NAC直径较小的患者进行隆胸的简单手术方法，该方法采用另一种乳晕周围入路，以产生与传统乳晕周围切口相似的瘢痕。
传统的乳晕周围入路进行隆胸时，乳晕直径至少需要3 cm。我们利用几何计算得出直径在2至2.9 cm之间的半圆的周长和面积值，这些值与直径为3 cm的圆的计算值相似。我们将这些结果应用于我们的手术技术。在乳晕下半边缘采用锯齿状模式做一个新月形切口，并去除该区域的表皮。通过乳腺实质并经外弓进行解剖。将乳房下皱襞充分降低，以便在切口闭合时植入物能位于乳头下方中央。插入硅胶填充的植入物，将切口的下边缘重叠到去上皮化的上瓣上，使伤口边缘分层连接并封闭，无需荷包缝合支撑。
2002年6月至2004年6月期间，我们对10例乳晕直径在2.2至2.8 cm之间、要求使用粘性凝胶或液体硅胶填充植入物进行初次隆胸的患者采用了该技术。8例患者的瘢痕颜色和质量令人满意；2例患者的瘢痕外侧增宽。与原始直径相比，所有患者的乳晕直径均有轻微变化，但无畸形。
这种简单的手术方法是NAC直径较小的患者隆胸手术的一种有效替代技术。
