Amini Peymaneh, Stasch Tilman, Theodorou Panagiotis, Altintas Ahmed Ali, Phan Vu, Spilker Gerald
Department of Plastic and Reconstructive Surgery, Hand Surgery and Burn Care Centre, Cologne City Hospitals (Merheim), University of Witten/Herdecke, Witten, Germany.
Ann Plast Surg. 2010 Mar;64(3):279-85. doi: 10.1097/SAP.0b013e3181b0a5d8.
Vertical reduction mammaplasty using a superomedial pedicle is a well-accepted technique giving good results in mild to moderate breast hypertrophy. We describe modifications of the vertical reduction technique to achieve safe reductions even for very large breasts and minimize unsightly scarring, skin necrosis and poor shape. Over the past 4 years, 162 patients have undergone bilateral breast reduction using the vertical mammaplasty technique with a superomedial dermoglandular pedicle. We present a retrospective study of 23 cases of gigantomastia (reductions over 1100g) who underwent bilateral reduction mammaplasty, using our technique. The mean age was 49 years, BMIs ranged from 28 to 52 kg/m. The mean suprasternal notch-to-nipple distance was 40.5 cm on the right and 41.4 cm on the left. The average resection weight per breast was 1303 g on the right, and 1245 g on the left side. The suprasternal notch-to-nipple distance was reduced by between 13.2 and 36.0 cm (mean, 16.1 cm). Mean follow-up was 14 months. We observed a superficial infection in 2 patients, a deep hematoma in one patient, partial necrosis of the nipple-areola complex in 1, and 2 patients needed correction surgery due to dog-ear formation. By using the described modifications, the nipple and areola were safely transposed on a superomedial dermoglandular pedicle producing good breast shapes, while scarring and complications in vertical reduction mammaplasty for oversized breasts were effectively minimized.
采用上内侧蒂的垂直双蒂乳房缩小术是一种广泛认可的技术，在轻至中度乳房肥大的治疗中效果良好。我们描述了对垂直双蒂技术的改良，即使对于非常大的乳房也能实现安全缩小，并将难看的疤痕、皮肤坏死和不良外形降至最低。在过去4年中，162例患者采用上内侧真皮腺体蒂垂直双蒂乳房缩小术进行了双侧乳房缩小。我们对23例巨乳症（切除量超过1100g）患者进行了回顾性研究，这些患者采用我们的技术进行了双侧乳房缩小术。平均年龄为49岁，体重指数范围为28至52kg/m²。右侧胸骨上切迹至乳头的平均距离为40.5cm，左侧为41.4cm。每侧乳房的平均切除重量右侧为1303g，左侧为1245g。胸骨上切迹至乳头的距离减少了13.2至36.0cm（平均16.1cm）。平均随访14个月。我们观察到2例患者发生浅表感染，1例患者出现深部血肿，1例乳头乳晕复合体部分坏死，2例患者因出现“猫耳”畸形需要进行矫正手术。通过采用所描述的改良方法，乳头和乳晕安全地转移至上内侧真皮腺体蒂上，形成了良好的乳房外形，同时有效减少了超大乳房垂直双蒂乳房缩小术中的疤痕和并发症。
