Aesthet Surg J. 2011 Aug;31(6):658-66. doi: 10.1177/1090820X11415241.
Single-stage, durable aesthetic contouring of the volume-depleted and ptotic breast remains a challenge for plastic and reconstructive surgeons. These challenges are often even more difficult in the patient who has undergone massive weight loss (MWL).
The authors describe their technique of reshaping the breasts of MWL patients with laterally-based breast flaps during a superomedial pedicle breast lift.
A total of 20 patients were treated in a private clinic by one of the authors between April 2006 and January 2010 were included in this study. Each patient underwent breast reshaping with mastopexy, lateral breast autoaugmentation, and implant insertion. A laterally-based breast flap was developed to augment the involuted and ptotic breast and was dissected in conjunction with the superomedial pedicle breast lift to maintain the implant position, prevent bottoming out, and provide tissue coverage between the skin and breast implant in the advent of wound breakdown.
Mean follow-up for this patient series was 19.5 months (range, two to 47). The average patient age was 41 years (range, 21 to 56), and the majority of patients had Grade 2 ptosis (14 out of 20). The average volume of the implants in this study was 350 cc (range, 275 to 600). There were no instances of seroma or wound infection. Five patients had minor instances of wound breakdown, but none required surgical revision. One patient developed early capsular contracture and required revision. That same patient developed a small hematoma. Patient self-evaluation revealed a high level of satisfaction; all 20 patients reported being happy with their results.
The laterally-based breast flap, in combination with the superomedial pedicle mastopexy, is a powerful tool for use in the postbariatric or postpartum patient in whom the majority of the breast parenchyma is needed to fill the skin envelope. This flap serves to improve overall breast shape by providing added tissue along the deficient inferior pole, relieving some of the unaesthetic lateral chest wall excess and providing an additional layer of support inferiorly along the fold.
对于整形和重建外科医生来说，对体积减少和下垂的乳房进行单阶段、持久的美容塑形仍然是一个挑战。在经历过大量体重减轻（MWL）的患者中，这些挑战甚至更加困难。
作者描述了他们在超级内侧蒂乳房提升术（superomedial pedicle breast lift）中使用侧向乳房皮瓣重塑 MWL 患者乳房的技术。
2010 年 1 月期间，作者之一在一家私人诊所治疗了 20 名患者，将他们纳入本研究。每位患者均接受乳房整形术、外侧乳房自体增强术和植入物插入术。开发了一个侧向乳房皮瓣来增强退化和下垂的乳房，并与超级内侧蒂乳房提升术一起解剖，以保持植入物位置、防止底部外露，并在伤口破裂时提供皮肤和乳房植入物之间的组织覆盖。
该患者系列的平均随访时间为 19.5 个月（范围，2 至 47 个月）。患者平均年龄为 41 岁（范围，21 至 56 岁），大多数患者为 2 级下垂（20 例中有 14 例）。本研究中植入物的平均体积为 350cc（范围，275 至 600cc）。没有血清肿或伤口感染的情况。5 例患者出现轻微伤口破裂，但均无需手术修复。1 例患者发生早期包膜挛缩，需要修订。同一位患者发生了小血肿。患者自我评估显示出高度的满意度；20 名患者均对结果表示满意。
侧向乳房皮瓣与超级内侧蒂乳房成形术相结合，是一种强大的工具，可用于大多数乳房实质需要填充皮肤包膜的减肥后或产后患者。该皮瓣通过提供沿缺陷下极的额外组织来改善整体乳房形状，减轻一些不美观的侧胸壁多余，并在褶皱下方提供额外的支撑层。
