Shin Hee Su, Lee Yong Hae, Jung Sung Gyun, Lee Doo Hyung, Roe Young, Cha Jong Hyun
Department of Plastic and Reconstructive Surgery, Konyang University College of Medicine, Daejeon, Korea.
Arch Plast Surg. 2015 Jul;42(4):446-52. doi: 10.5999/aps.2015.42.4.446. Epub 2015 Jul 14.
Various techniques are used for performing breast reduction. Wise-pattern and vertical scar techniques are the most commonly employed approaches. However, a vertical scar in the mid-lower breast is prominent and aesthetically less pleasant. In contrast, a semicircular horizontal approach does not leave a vertical scar in the mid breast and transverse scars can be hidden in the inframammary fold. In this paper, we describe the experiences and results of semicircular horizontal breast reductions performed by a single surgeon.
Between September 1996 and October 2013, our senior author used this technique in 38 cases in the US and at our institution. We used a superiorly based semicircular incision, where the upper skin paddle was pulled down to the inframammary fold with the nipple-areola complex pulled through the keyhole.
The average total reduction per breast was 584 g, ranging from 286 to 794 g. The inferior longitudinal pedicle was used in all the cases. The average reduction of the distance from the sternal notch to the nipple was 13 cm (range, 11-15 cm). The mean decrease in the bra cup size was 1.7 cup sizes (range, a decrease of 1 to 3). We obtained very satisfactory results with a less noticeable scar, no complication such as necrosis of the nipple or the skin flap, wound infection, aseptic necrosis of the breast tissue, or wound dehiscence. One patient had a small hematoma that resolved spontaneously.
This technique is straightforward and easy to learn, and offers a safe, effective, and predictable way for treating mammary hypertrophy.
多种技术可用于乳房缩小术。 Wise 术式和垂直瘢痕技术是最常用的方法。然而，乳房中下部分的垂直瘢痕较为明显，美观度欠佳。相比之下，半圆形水平切口法不会在乳房中部留下垂直瘢痕，横向瘢痕可隐藏在乳房下皱襞中。在本文中，我们描述了由一位外科医生实施半圆形水平乳房缩小术的经验和结果。
1996 年 9 月至 2013 年 10 月期间，我们的资深作者在美国及我们机构对 38 例患者使用了该技术。我们采用了以乳房上方为蒂的半圆形切口，将上方皮瓣向下牵拉至乳房下皱襞，乳头乳晕复合体通过锁孔牵拉。
每侧乳房平均总切除量为 584 克，范围为 286 至 794 克。所有病例均采用下方纵向蒂。从胸骨切迹到乳头的平均距离缩短了 13 厘米（范围为 11 - 15 厘米）。胸罩罩杯尺寸平均减小 1.7 个罩杯（范围为减小 1 至 3 个罩杯）。我们获得了非常满意的效果，瘢痕不太明显，未出现乳头或皮瓣坏死、伤口感染、乳腺组织无菌性坏死或伤口裂开等并发症。1 例患者出现小血肿，自行消退。
该技术简单易学，为治疗乳腺肥大提供了一种安全、有效且可预测的方法。
