Novaković Marijan, Lukac Marija, Kozarski Jefta, Stepić Nenad, Djordjević Boban, Vulović Dejan, Rajović Milica, Milev Bosko, Milićević Sasa
Military Medical Academy, Clinic for Plastic Surgery and Burns, Belgrade, Serbia.
Vojnosanit Pregl. 2010 Apr;67(4):313-20. doi: 10.2298/vsp1004313n.
BACKGROUND/AIM: There is a natural asymmetry in normal female brests. When the difference in the shape, size or position of the breast and nipple-areola complex is visible, surgical correction is the only treatment option and presents one of the greatest challenges for a plastic surgeon. Based on the Nahai classification presented in details, the aim of the study was to present the possibilities of plastic surgery to correct primary (congenital), secondary (developmental) and tertiary (acquired) brest asymmetries.
We conducted a retrospective analysis of female breast asymmetry surgeries performed in the Clinic for Plastic Surgery and Burns, Military Medical Academy (MMA), Belgrade over the last seven years (January 2002 - January 2009).
During the above mentioned period, 82 female patients, 18 - 65 years of age, underwent surgery for breast asymmetry. The most frequent asymmetries were developmental, "pubertal" (n = 43); acquired asymmetries as a consequence of tumor surgery were found in the other 22 patients, while 7 patients were diagnosed with primary asymmetries such as congenital chest-wall asymmetry (Sy. Poland), accessory and tuberous breasts. All patients underwent preoperative ultrasound examination, while hormone status was determined in those with developmental, "pubertal" asymmetries. The selection of surgical procedure for correction of breast asymmetry depended upon clinical examination findings and patient's wish relating to the shape and size of the breasts. The most of breast asymmetries were corrected by a combination of surgical procedures including primary and secondary reconstruction, reduction, suspension or augmentation mammoplasty. Having combined different surgical procedures, we managed to achive satisfactory results. The hypertrophic scar formation after reduction mamoplasty was seen in some cases, however, they caused no significant patient's discomfort.
Application of plastic, reconstructive and aesthetic surgical principles can considerably contribute to achieving excellent results in corrective surgery for breast asymmetries. In addition to most suitable breast asymmetry surgical procedures choice, motivation of a patient is also very important for achieving satisfactory results.
背景/目的：正常女性乳房存在自然不对称性。当乳房及乳头乳晕复合体的形状、大小或位置差异明显可见时，手术矫正为唯一的治疗选择，也是整形外科医生面临的最大挑战之一。基于详细介绍的纳海分类法，本研究旨在探讨通过整形手术矫正原发性（先天性）、继发性（发育性）和第三性（后天性）乳房不对称的可能性。
我们对过去七年（2002年1月至2009年1月）在贝尔格莱德军事医学科学院整形外科与烧伤科进行的女性乳房不对称手术进行了回顾性分析。
在上述期间，82例年龄在18至65岁的女性患者接受了乳房不对称手术。最常见的不对称类型为发育性“青春期”不对称（n = 43）；另外22例患者因肿瘤手术导致后天性不对称，7例患者被诊断为原发性不对称，如先天性胸壁不对称（波兰综合征）、副乳和乳房畸形。所有患者术前均接受了超声检查，对于发育性“青春期”不对称患者还测定了激素状态。乳房不对称矫正手术的选择取决于临床检查结果以及患者对乳房形状和大小的期望。大多数乳房不对称通过包括一期和二期重建、缩小、悬吊或隆乳术在内的联合手术进行矫正。通过联合不同的手术方法，我们取得了满意的效果。部分病例在缩乳术后出现了增生性瘢痕形成，但未给患者带来明显不适。
整形、重建和美容外科原则的应用可显著有助于在乳房不对称矫正手术中取得优异效果。除了选择最合适的乳房不对称手术方法外，患者的积极性对于取得满意效果也非常重要。
