Bitik Ozan, Uzun Hakan
Department of Plastic Surgery, Hacettepe University Faculty of Medicine, Sihhiye, 06100, Ankara, Turkey.
Department of Plastic Surgery, Cleveland Clinic Foundation, 9500 Euclid Avenue, Cleveland, OH, 44195, USA.
Aesthetic Plast Surg. 2016 Oct;40(5):690-8. doi: 10.1007/s00266-016-0663-4. Epub 2016 Jun 29.
Postoperative changes following superior pedicle breast reduction are closely related to the pattern of skin resection. We have observed that the superior pedicle, short horizontal scar breast reduction technique provides a stable breast shape in the long term. We test the validity of our clinical observations through objective analysis of postoperative dimensional changes following superior pedicle, short horizontal scar breast reduction.
Of 42 patients who underwent superior pedicle, short horizontal scar breast reductions between January 2011 and June 2012, 38 (75 breasts) were available for long-term follow-up. The midclavicular point-to-superior areolar border distance (A), the inferior areolar border-to-inframammary fold (IMF) distance (B), and the areolar diameter (C) were measured and recorded at the time of (1) preoperative markings, (2) first postoperative visit, and (3) 2-year postoperative follow-up visit. The specifications of the preoperative markings were recorded to analyze their correlation with actual breast dimensions.
The superior border of the nipple-areola complex (NAC) was located, on average, 1.2 cm higher at the first postoperative visit when compared with the markings (P < 0.001). The nipple-areola position did not change significantly in the long term (P = 0.224). The average postoperative increase in the IMF-to-inferior areolar border distance between the first postoperative visit and the long-term follow-up visit was 0.3 cm (P < 0.001). Although statistically significant, this extent of change (4.5 %) in the lower pole vertical length was clinically unidentifiable, and pseudoptosis did not occur after superior pedicle, short horizontal scar mammaplasty.
Long-term stability of the NAC position and lower breast pole length makes superior pedicle, short horizontal scar breast reduction a predictable and dependable option for primary breast reduction/mastopexy and for a matching procedure.
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上蒂乳房缩小术后的变化与皮肤切除模式密切相关。我们观察到,上蒂、短水平瘢痕乳房缩小技术能长期提供稳定的乳房形态。我们通过对上蒂、短水平瘢痕乳房缩小术后尺寸变化的客观分析来检验我们临床观察结果的有效性。
在2011年1月至2012年6月期间接受上蒂、短水平瘢痕乳房缩小术的42例患者中,38例(75侧乳房)可进行长期随访。在以下三个时间点测量并记录锁骨中点至上乳晕边缘距离(A)、下乳晕边缘至乳房下皱襞(IMF)距离(B)以及乳晕直径(C):(1)术前标记时;(2)术后首次复诊时;(3)术后2年随访时。记录术前标记的规格,以分析其与实际乳房尺寸的相关性。
术后首次复诊时,乳头乳晕复合体(NAC)上缘平均比标记位置高1.2 cm(P < 0.001)。从长期来看,乳头乳晕位置无显著变化(P = 0.224)。术后首次复诊至长期随访期间,IMF至下乳晕边缘距离的平均增加量为0.3 cm(P < 0.001)。尽管在统计学上有显著意义,但下极垂直长度的这种变化程度(4.5%)在临床上无法识别,且上蒂、短水平瘢痕乳房成形术后未发生假下垂。
NAC位置和乳房下极长度的长期稳定性使上蒂、短水平瘢痕乳房缩小术成为一期乳房缩小/乳房上提术及配套手术的可预测且可靠的选择。
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