Galych Sergey P, Dabizha Oleksii Y, Kostenko Alona A, Gomolyako Irina V, Samko Kristina A, Borovyk Denys V
Department of Microvascular, Plastic and Reconstructive Surgery; and the Laboratory of Pathomorphology and Cytology, Plastic and Reconstructive Surgery, National Institute of Surgery and Transplantology Named after Shalimov O. O. of the National Academy of Medical Sciences of Ukraine, Kyiv, Ukraine.
Plast Reconstr Surg Glob Open. 2016 Oct 10;4(10):e1024. doi: 10.1097/GOX.0000000000001024. eCollection 2016 Oct.
Tubular breasts are caused by connective tissue malformation and occur in puberty. The main clinical characteristics of the tubular breast are breast asymmetry, dense fibrous ring around the areola, hernia bulging of the areola, megaareola, and hypoplasia of quadrants of the breast. Pathology causes great psychological discomfort to patients.
This study included 17 patients, aged 18 to 34 years, with tubular breast type II who had bilateral pathology and were treated from 2013 to 2016. They had surgical treatment by method of the clinic. Correction technique consisted of mobilization of the central part of the gland and formation of a glandular flap with vertical and horizontal scorings, which looks like a "chessboard," that was sufficient to cover the lower pole of the implant. The flap was fixed to the submammary folds with stitches that prevented its reduction and accented a new submammary fold. To underscore the importance of the method and to study the structural features of the vascular bed of tubular breast tissue, a morphological study was conducted.
Mean follow-up time was 25 months (range between 13 and 37 mo). The proposed technique achieved good results. Complications (hematoma, circumareolar scarring, and "double-bubble" deformity) were identified in 4 patients.
Our morphological study confirmed that tubular breast tissue has increased vascularity due to the vessels with characteristic minor malformation and due to the high restorative potential of the vascular bed. Therefore, an extended glandular flap could be freely mobilized without damaging its blood supply; thus, the flap in most cases covered the implant completely and good aesthetic results were achieved.
管状乳房由结缔组织畸形引起,发生于青春期。管状乳房的主要临床特征为乳房不对称、乳晕周围致密纤维环、乳晕疝样隆起、乳晕过大以及乳房象限发育不全。病理情况给患者造成极大的心理不适。
本研究纳入了17例年龄在18至34岁之间、患有双侧病变的II型管状乳房患者,这些患者于2013年至2016年接受治疗。他们采用临床方法进行手术治疗。矫正技术包括腺体中央部分的游离以及通过垂直和水平划痕形成腺瓣,该腺瓣形似“棋盘”,足以覆盖植入物的下极。用缝线将腺瓣固定于乳房下皱襞,防止其回缩并突出新的乳房下皱襞。为强调该方法的重要性并研究管状乳房组织血管床的结构特征,进行了形态学研究。
平均随访时间为25个月(范围在13至37个月之间)。所提出的技术取得了良好效果。4例患者出现了并发症(血肿、乳晕周围瘢痕形成和“双泡”畸形)。
我们的形态学研究证实,由于具有特征性微小畸形的血管以及血管床的高修复潜力,管状乳房组织的血管增多。因此,可自由游离扩展的腺瓣而不损害其血供;这样,在大多数情况下腺瓣能完全覆盖植入物并取得良好的美学效果。