Stalder Mark W, Accardo Katherine, Allen Robert J, Sadeghi Alireza
New Orleans, La.; and New York, N.Y. From the Division of Plastic and Reconstructive Surgery, Louisiana State University Health Sciences Center; and the Institute of Reconstructive Plastic Surgery, New York University School of Medicine.
Plast Reconstr Surg. 2015 Sep;136(3):455-461. doi: 10.1097/PRS.0000000000001561.
The abdominal donor site has consistently demonstrated excellent aesthetic outcomes when used for autologous breast reconstruction. However, a consistent point of dissatisfaction is the location and appearance of the abdominal donor-site scar, which can be a frequent cause of distress for the patient. The authors consider the appearance of the donor-site to be as important to the overall reconstructive effort as that of the breast, and believe it worthwhile to achieve an aesthetically pleasing result. Thus, the authors present here their technique for aesthetic revision of the abdominal donor site after autologous breast reconstruction.
This is a series of 51 patients who underwent autologous tissue breast reconstruction with deep inferior epigastric perforator flaps. All patients subsequently underwent abdominal donor-site revision during the second stage of their reconstruction, including excision and lowering of the abdominal scar, and liposuction of the abdomen and mons pubis to achieve optimum contouring.
The donor-site scars were lowered an average of 5.93 cm (range, 5 to 7 cm). The average procedural time was 27 minutes. No wound dehiscence, seromas, hematomas, or infections were reported postoperatively.
With this report, the authors put forth a new obtainable standard for autologous tissue breast reconstruction donor-site aesthetics, and propose a conceptual shift that includes the trunk aesthetic unit as an integral part of the overall reconstructive outcome. The authors' results here demonstrate that this is a safe, successful, and reproducible procedural adjunct to the second stage of breast reconstruction.
腹部供区用于自体乳房重建时，一直展现出出色的美学效果。然而，一个持续存在的不满之处在于腹部供区瘢痕的位置和外观，这可能是患者苦恼的常见原因。作者认为供区的外观对于整体重建效果与乳房外观同样重要，并认为实现美观的效果是值得的。因此，作者在此介绍他们在自体乳房重建后对腹部供区进行美学修复的技术。
这是一组51例接受腹壁下深动脉穿支皮瓣自体组织乳房重建的患者。所有患者随后在重建的第二阶段接受了腹部供区修复，包括切除并降低腹部瘢痕，以及对腹部和耻骨联合进行吸脂以实现最佳塑形。
供区瘢痕平均降低了5.93厘米（范围为5至7厘米）。平均手术时间为27分钟。术后未报告伤口裂开、血清肿、血肿或感染情况。
通过本报告，作者提出了自体组织乳房重建供区美学的一个新的可实现标准，并提出了一种观念转变，即将躯干美学单元作为整体重建效果的一个组成部分。作者在此的结果表明，这是乳房重建第二阶段一种安全、成功且可重复的手术辅助方法。
