Ogawa Tomoko, Hanamura Noriko, Yamashita Masako, Kimura Hiroko, Kashikura Yumi
Department of Breast Surgery, Mie University Graduate School of Medicine, Mie 514-8507, Japan.
Plast Surg Int. 2011;2011:359842. doi: 10.1155/2011/359842. Epub 2011 Sep 20.
We defined the glandular flap including fat in the subclavicular area as an extended glandular flap, which has been used for breast-conserving reconstruction in the upper portion of the breast. Indication. The excision volume was 20% to 40% of the breast volume, and the breast density was dense. Surgical Technique. The upper edge of the breast at the subclavicular area was drawn in the standing position before surgery. After partial mastectomy, an extended glandular flap was made by freeing the breast from both the skin and the pectoralis fascia up to the preoperative marking in the subclavicular area. It is important to keep the perforators of the internal mammary artery and/or the branches of the lateral thoracic artery intact while making the flap. Results. Seventeen patients underwent remodeling using an extended glandular flap. The cosmetic results at 1 year after the operation: excellent in 11, good in 1, fair in 3, and poor in 2. All cases of unacceptable outcome except one were cases with complications, and more than 30% resection of moderate or large size breasts did not obtain an excellent result for long-term followup. Conclusion. This technique is useful for performing the breast-conserving reconstruction of small dense breasts.
我们将包含锁骨下区域脂肪的腺体瓣定义为扩展腺体瓣，其已用于乳房上部的保乳重建。适应证。切除体积为乳房体积的20%至40%，且乳房密度较高。手术技术。术前在站立位画出乳房在锁骨下区域的上缘。部分乳房切除术后，通过将乳房从皮肤和胸大肌筋膜游离至锁骨下区域的术前标记处来制作扩展腺体瓣。制作皮瓣时，保持胸廓内动脉穿支和/或胸外侧动脉分支完整很重要。结果。17例患者使用扩展腺体瓣进行了重塑。术后1年的美容效果：11例优秀，1例良好，3例尚可，2例差。除1例之外，所有不可接受的结果均为有并发症的病例，对于中、大尺寸乳房超过30%的切除在长期随访中未获得优秀结果。结论。该技术对于小而致密乳房的保乳重建有用。
