San Martino University Hospital, Genoa, Italy.
Obes Surg. 2010 May;20(5):651-6. doi: 10.1007/s11695-009-0058-6. Epub 2010 Jan 7.
Breast deformities in postbariatric surgery (post-BS) patients are different and more challenging than those from non-BS patients. The histological alterations confer the highest clinical consequences to this area: highest degrees of true ptosis, deflated and flattened glands, and totally inelastic covering tissues. Plastic surgeons need an easy-to-use algorithm for technical choices.
Ptosis and volume loss are the main problems to be corrected on massive-weight-loss (M.W.L.) breasts. Both problems need specific resolutions due to their specific characteristics. Depending on the degree of ptosis and the amount of volume loss, a decisional algorithm has been developed: suitable and advisable techniques are pointed out, minimizing the risk/benefit ratio. "Pros and cons" with the use of mammary implants are emphasized.
A group of 195 postbariatric surgery patients underwent breast contouring since 2001 following the herein presented decisional algorithm. Results have been tested with Body Uneasiness Test: encouraging data pushed to continue this method and to refine it.
Referring to this strategy algorithm, choices 2 and 3 appear to be the more frequently applied and better fitted to cover the majority of M.W.L. breast defects. In the future, the birth and the rise of new mammary implant concepts and technologies could completely change this algorithm.
与非减重手术（BS）患者相比，减重手术后（post-BS）患者的乳房畸形更为复杂和具有挑战性。组织学改变给该区域带来了最高的临床后果：真正的下垂程度最高、腺体瘪平和扁平、覆盖组织完全无弹性。整形外科医生需要一个易于使用的技术选择算法。
在大量体重减轻（M.W.L.）的乳房中，下垂和体积损失是需要纠正的主要问题。由于其特定的特征，这两个问题都需要特定的解决方案。根据下垂的程度和体积损失的程度，已经制定了决策算法：指出了合适和可取的技术，将风险/收益比降到最低。强调了使用乳房植入物的“利弊”。
自 2001 年以来，根据本文提出的决策算法，195 名接受过减重手术的患者接受了乳房整形手术。结果已经通过身体不适测试进行了测试：令人鼓舞的数据促使我们继续使用这种方法并对其进行改进。
参考这一策略算法，选择 2 和 3 似乎是应用最广泛和最适合覆盖大多数 M.W.L.乳房缺陷的方法。在未来，新的乳房植入物概念和技术的出现可能会彻底改变这一算法。
