Berrino P, Franchelli S, Santi P
Department of Plastic Surgery, National Institute for Cancer Research, Genoa, Italy.
Ann Plast Surg. 1990 Jun;24(6):481-8. doi: 10.1097/00000637-199006000-00003.
Breast deformities following long-lasting complications associated with the use of polyurethane prostheses are encountered with increasing frequency in our practice. Patients with this problem often feel frustrated after a long period of unsuccessful treatment and multiple operations. The anatomopathological bases of the deformity in such patients can be summarized as follows: volumetric mammary defect, soft tissue deficiency, and distortion and fibrosis of residual breast tissues. The reconstructive procedure should provide adequate aesthetic results with permanent or long-lasting symmetry, possibly in a single operative stage. The procedures employed in 12 patients are reviewed, and 3 representative cases are described in detail. The best aesthetic results in difficult cases have been achieved with either a latissimus dorsi muscular flap raised through minimal posterior incisions and transposed anteriorly to cover a permanent, expandable implant, or a suitably tailored, partly deepithelialized transverse rectus abdominis musculocutaneous flap.
在我们的临床实践中，因使用聚氨酯假体而出现长期并发症后导致的乳房畸形越来越常见。患有这个问题的患者在经历了长时间的治疗失败和多次手术之后，往往会感到沮丧。这类患者乳房畸形的解剖病理学基础可概括如下：乳房体积缺失、软组织不足以及残留乳腺组织的变形和纤维化。重建手术应能实现足够美观的效果，保持永久或长期的对称，最好能在单一手术阶段完成。本文回顾了12例患者所采用的手术方法，并详细描述了3个具有代表性的病例。在困难病例中，通过以下两种方法可获得最佳美学效果：一是通过最小限度的后外侧切口掀起背阔肌肌皮瓣并向前转移，以覆盖永久性可扩张假体；二是使用适当剪裁、部分去上皮化的腹直肌肌皮瓣。
