Division of Plastic and Reconstructive Surgery, Faculty of Health Sciences, University of Stellenbosch, Tygerberg Campus, Bellville, Western Cape, South Africa.
Aesthetic Plast Surg. 2012 Jun;36(3):578-89. doi: 10.1007/s00266-011-9845-2. Epub 2011 Nov 20.
The reasons for recurrent ptosis in mastopexy and breast reduction procedures are twofold. First, available surgical techniques do not reconstruct the normal breast anatomy responsible for maintaining breast shape. Second, in many instances the techniques rely on atrophied tissue to provide long-term support. The discovery in 1997 of the ligamentous suspension (the supporting system of the breast) gave rise to the concept that reconstruction of this anatomical structure was needed to ensure a sustained postoperative result. Applying the latest knowledge regarding the structural and vascular anatomy of the breast in the surgical technique and utilizing material other than atrophied breast tissue enabled us to prevent the recurrence of breast ptosis.
A surgical technique was developed to replace the supportive function of a failed ligamentous suspension in 112 patients with ptotic breasts. This was done by reconstructing an internal breast-supporting system (IBSS) with biocompatible mesh.
Satisfactory breast shape, nipple projection, and upper breast fullness was obtained with this technique in mastopexy patients with moderate-sized ptotic breasts. In patients with larger breasts good results were obtained with a simultaneous breast reduction. The longest follow-up is 6 years 3 months.
With this technique recurrent breast ptosis can be prevented in mastopexy and breast reduction procedures. The results are such that it eliminates the need for silicone prostheses to obtain satisfactory upper-breast fullness. The surgical technique is especially indicated in patients with skin of poor quality or patients with high expectations.
乳房上提和乳房缩小术后出现复发性上睑下垂的原因有两个。首先，现有的手术技术不能重建负责维持乳房形状的正常乳房解剖结构。其次，在许多情况下，这些技术依赖于萎缩的组织来提供长期的支撑。1997 年韧带悬吊术（乳房的支撑系统）的发现，使得重建这一解剖结构的概念应运而生，以确保术后的持久效果。我们将乳房结构和血管解剖的最新知识应用于手术技术中，并使用不同于萎缩的乳房组织的材料，从而避免了乳房下垂的复发。
我们开发了一种手术技术，通过使用生物相容性网片来重建内部乳房支撑系统（IBSS），以替代 112 例乳房下垂患者失败的韧带悬吊的支撑功能。
对于中等大小乳房下垂的乳房上提患者，采用这种技术可获得满意的乳房形状、乳头突出和上乳房丰满度。对于乳房较大的患者，同时进行乳房缩小术可获得良好的效果。最长随访时间为 6 年 3 个月。
通过这种技术，乳房上提和乳房缩小术可预防复发性上睑下垂。其效果显著，可避免使用硅胶假体来获得满意的上乳房丰满度。该手术技术特别适用于皮肤质量较差或期望较高的患者。
