Universitat Internacional de Catalunya, Barcelona, Spain.
Aesthetic Plast Surg. 2012 Oct;36(5):1114-9. doi: 10.1007/s00266-012-9921-2. Epub 2012 Jun 1.
Treatment of tuberous breasts types 1 and 2 must deal with the problem of the pseudo-double bubble in the primitive inframammary fold and also must release the constrictive ring. Two techniques currently are used to overcome these problems, but neither is entirely satisfactory. The first technique, in which the approach is via the primitive inframammary fold, leaves significant scarring when the lower poles expand. The second technique, in which the approach is periareolar, considerably reduces the area's sensitivity. This report presents a new endoscopically assisted technique with an axillary approach designed to solve these problems.
Between 2005 and 2010, 68 patients (ages 18-42 years) underwent surgery. The intervention was bilateral in 57 and unilateral in 11 of these patients. All cases involved tuberous breasts types 1 and 2 (Grolleau's classification). The augmentation involves a transaxillary subfascial endoscopic approach, opening of the fascia at the primitive inframammary fold, and releasing of the constricting ring to enable the breast to expand, followed by implantation of an anatomic prosthesis to add volume to the lower quadrants. If the pseudo-double bubble appears, fat grafting is applied during the same surgical procedure.
The results were reported to be highly satisfactory both by the patients and by the independent medical team. For six patients (8.82 %), fat grafting had to be repeated in the double bubble. No major complications were reported.
The endoscopically assisted subfascial breast augmentation technique obtains highly satisfactory results in tuberous breasts types 1 and 2 (Grolleau's classification). The single scar is concealed in the axillary fold.
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治疗 1 型和 2 型乳状瘤必须解决原始乳晕下假性双泡的问题，还必须释放缩窄环。目前有两种技术可用于克服这些问题，但都不完全令人满意。第一种技术，即通过原始乳晕下进行手术，当下极扩张时会留下明显的疤痕。第二种技术，即经乳晕周围进行手术，会大大降低该区域的敏感性。本报告介绍了一种新的经腋路内窥镜辅助技术，旨在解决这些问题。
2005 年至 2010 年间，有 68 名患者（18-42 岁）接受了手术。其中 57 例为双侧手术，11 例为单侧手术。所有病例均为 1 型和 2 型乳状瘤（Grolleau 分类）。该干预措施涉及经腋路筋膜下内窥镜辅助，在原始乳晕下打开筋膜，释放缩窄环以使乳房扩张，然后植入解剖假体以增加下象限的体积。如果出现假性双泡，则在同一手术过程中进行脂肪移植。
患者和独立医疗团队均报告结果非常满意。对于 6 名患者（8.82%），需要在双泡处再次进行脂肪移植。未报告重大并发症。
经腋路内窥镜辅助筋膜下乳房增大技术可获得 1 型和 2 型乳状瘤（Grolleau 分类）的高度满意结果。单一疤痕隐藏在腋窝褶皱中。
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