Providence, R.I. From the Department of Plastic Surgery, Brown University School of Medicine, Rhode Island Hospital.
Plast Reconstr Surg. 2009 Nov;124(5):1662-1672. doi: 10.1097/PRS.0b013e3181babd02.
The purpose of this article is to describe a novel technique of providing autologous tissues for breast augmentation and simultaneously rejuvenating the abdomen.
Thirty-seven patients underwent augmentation mammaplasty by reverse abdominoplasty (AMBRA) between 1997 and 2006. The upper abdominal pannus present in women whose lower abdomen was typically less aesthetically compromised was harvested as deepithelialized adipofascial flaps, maintaining their connection to and thus blood supply from the attached breast parenchyma. These flaps are transposed subglandularly, creating autologous tissue breast implants, and reverse abdominoplasty accomplishes donor-site closure and aesthetic improvement. If previous surgery or inadequate inframammary fold tissue thickness renders the superior circulation unfavorable, the upper abdominal tissues can be used as advancement flaps vascularly supplied by their attachment to the abdominal skin apron.
Twenty-three patients (62 percent) had simultaneous mastopexy and 16 (43 percent) had simultaneous panniculectomy. Complications in the superior pedicle group were minimal. In the inferior pedicle group, complications were more extensive because of the premorbidity of this group of patients and the limitations of this technique, where the resuspension of the abdominal wall apron is less facile and generally weaker than closure with superiorly based flaps.
Augmentation mammaplasty by reverse abdominoplasty is a versatile procedure that in the carefully selected patient can successfully address two aesthetic concerns simultaneously, providing durable autologous tissue that can obviate or enhance the outcome provided by prosthetic implants and rejuvenating the abdomen. It also shows promise as a significant adjunct to the techniques available to the breast reconstructive surgeon.
本文旨在描述一种为乳房增大提供自体组织并同时使腹部年轻化的新技术。
1997 年至 2006 年间，37 名患者接受了反向腹成形术（AMBRA）的隆胸术。上腹部赘皮在腹部下部通常不太美观的女性中被采集为去上皮化的脂肪筋膜皮瓣，保持其与附着的乳房实质的连接，从而保持其血液供应。这些皮瓣被皮下转移，形成自体组织乳房植入物，反向腹成形术完成供体部位的闭合和美学改善。如果先前的手术或下乳晕组织厚度不足导致上循环不利，可将上腹部组织用作由其与腹部皮肤围裙的附着而提供的血管供应的推进皮瓣。
23 名患者（62%）同时进行了乳房上提术，16 名患者（43%）同时进行了腹脂切除术。上蒂组的并发症很少。在下蒂组，并发症更为广泛，因为这组患者的预发病和该技术的局限性，腹壁围裙的重新悬吊不如上蒂皮瓣的闭合那样容易且通常较弱。
反向腹成形术的隆胸术是一种多功能的手术，在精心选择的患者中，可以同时成功解决两个美学问题，提供持久的自体组织，可以避免或增强假体植入物提供的结果，并使腹部年轻化。它还显示出作为乳房重建外科医生可用技术的重要辅助手段的潜力。
