Serra M Paola, Longhi Paolo, Sinha Manish
Canniesburn Plastic Surgery Unit, Glasgow Royal Infirmary, Glasgow, United Kingdom.
Ann Plast Surg. 2010 Mar;64(3):275-8. doi: 10.1097/SAP.0b013e3181b0a611.
Vertical scar breast reduction has not achieved widespread acceptance and many still view it as a technique with certain limitations. We present the results of a vertical scar pattern breast reduction with superomedial pedicle (Hall-Findlay's technique) in a series of 210 breast reductions. A superomedial pedicle was used with no pectoralis fascial suspension sutures, no or minimal use of liposuction or skin undermining. Glanduloplasty sutures were used to shape the breast parenchyma and the vertical incision closed with less gathering. Reductions of up to 1100 g per side were successfully achieved. Satisfactory healing was observed in 96.7% patients. All patients had a satisfactory final breast shape.
11 dog ears (5.2%) of which 9 had a revision (4.2%), 1 puckering on the inframammary fold on one side (0.47%), which did not require a revision, 7 wound problems in the vertical component of the scar (3.3%), which spontaneously healed in 4 weeks, and 2 re-reduction for further reducing the weight of the breasts (0.95%). The total rate of complications was 10% while the revision rate was 5.2%. We validate Hall-Findlay's technique with our independent results. The technique combines the safety of the superomedial pedicle with advantages of a vertical scar in a quick but safe manner ensuring adequate resection and sound healing with less scars and faster recovery for the patient.
垂直瘢痕乳房缩小术尚未得到广泛认可,许多人仍认为它是一种存在一定局限性的技术。我们展示了一系列210例采用上内侧蒂垂直瘢痕模式乳房缩小术(霍尔 - 芬德利技术)的结果。使用上内侧蒂,未进行胸肌筋膜悬吊缝合,未使用或极少使用吸脂或皮下潜行分离。采用腺体成形缝线塑造乳腺实质,垂直切口闭合时聚拢较少。每侧成功实现了高达1100克的切除量。96.7%的患者愈合情况良好。所有患者最终乳房形态均令人满意。
11例出现“狗耳”(5.2%),其中9例进行了修复(4.2%);1例一侧乳房下皱襞出现褶皱(0.47%),无需修复;7例瘢痕垂直部分出现伤口问题(3.3%),4周内自行愈合;2例因进一步减轻乳房重量进行了再次缩小术(0.95%)。并发症总发生率为10%,修复率为5.2%。我们用独立结果验证了霍尔 - 芬德利技术。该技术以上内侧蒂的安全性与垂直瘢痕的优势相结合,以快速但安全的方式确保了充分切除和良好愈合,减少了瘢痕,使患者恢复更快。