Bhave Medha A
Department of Plastic and Cosmetic surgery, Param Hospital and ICU, Mumbai, Maharashtra, India.
Indian J Plast Surg. 2015 Sep-Dec;48(3):283-7. doi: 10.4103/0970-0358.173126.
Axillary breast is a common condition that leads to discomfort and cosmetic problems. Liposuction alone and open excision are two techniques used for treatment.
This study assesses the results of treatment in 24 consecutive patients, operated between 2005 and 2015. All patients had Kajava class IV masses. Three were treated by liposuction alone, while 21 were treated by open axillaplasty with limited liposuction.
One patient treated by liposuction alone had to be re-operated for a residual lump, while with axillaplasty, no major complications were observed and the results were uniformly good.
Certain points of technique emerged as major determinants in obtaining the best results. In brief, these are: a) limited skin excision; b) placing elliptical incisions within the most lax, apical axillary skin, irrespective of the location of the lump; c) raising skin flaps at the level of superficial fascia; d)meticulous dissection and preservation of the nerves, especially the second intercostobrachial; f) judicious liposuction for eliminating dog ears and axillary sculpting only; g) avoiding drains.
Open axillaplasty with limited liposuction is the best way to minimise complications and produce good results.
腋下副乳是一种常见病症，会导致不适和美观问题。单纯抽脂术和开放式切除术是两种治疗方法。
本研究评估了2005年至2015年间连续24例接受手术患者的治疗结果。所有患者均为卡亚瓦IV级肿块。3例仅接受抽脂术治疗，21例接受有限抽脂的开放式腋窝成形术治疗。
仅接受抽脂术治疗的1例患者因残留肿块需再次手术，而腋窝成形术未观察到重大并发症，效果均良好。
某些技术要点成为获得最佳效果的主要决定因素。简而言之，这些要点包括：a）有限的皮肤切除；b）无论肿块位置如何，在腋窝最松弛的顶端皮肤内做椭圆形切口；c）在浅筋膜层面掀起皮瓣；d）仔细解剖并保留神经，尤其是第二肋间臂神经；f）仅为消除皮赘和塑造腋窝进行明智的抽脂；g）避免放置引流管。
有限抽脂的开放式腋窝成形术是将并发症降至最低并取得良好效果的最佳方法。
