Karacaoglu Ercan, Zienowicz Richard J
Division of Plastic Surgery, Atasehir Memorial Hospital, Istanbul, Turkey.
Division of Plastic Surgery, Warren Alpert Medical School, Brown University, Rhode Island Hospital, Providence, RI, USA.
Aesthetic Plast Surg. 2017 Feb;41(1):1-9. doi: 10.1007/s00266-016-0763-1. Epub 2016 Dec 28.
BACKGROUND: Reduction in breasts with well-preserved nipple sensation and a viable nipple-areola complex (NAC) is one of the basic core concepts of reduction mammoplasty. Many techniques have been described with enthusiasm advocating full achievement of the aforementioned goals. The goal of this study is to introduce a novel technique that provides an intact neurovascular source to the nipple-areola complex for reduction in gigantic breasts. PATIENTS AND METHODS: Twenty-six patients operated on from December 2010 through April 2015 were included in the study. The reduction was performed by isolating Wuringer's septum and the inferior pedicle in continuity with the medial pedicle to save the neurovascular supply to the NAC and its accompanying breast parenchyma. This pedicle is called as septum-inferior-medial-based pedicle. Inclusion criteria, marking and planning with detailed description of the surgical procedure are presented. RESULTS: The overall satisfaction rate was high. Eighty percent of the patients rated their results. The results were as follows: 81% rated as 'very satisfied'; 19% rated as 'somewhat satisfied.' NAC sensation was intact in all cases at all time intervals even immediately after surgery. CONCLUSION: The united pedicle technique provides an intact neurovascular source to the nipple-areola complex. Reduction with this pedicle is a safe procedure. Remodeling the gigantic breast can be accomplished without any restriction because of the flexibility of this pedicle. The very early results are promising, but long-term results needed to be evaluated. LEVEL OF EVIDENCE IV: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
背景:保留乳头感觉且乳头乳晕复合体(NAC)存活的乳房缩小术是乳房缩小整形术的基本核心概念之一。人们热情地描述了许多技术,主张完全实现上述目标。本研究的目的是介绍一种为巨大乳房缩小术提供完整神经血管来源至乳头乳晕复合体的新技术。 患者与方法:本研究纳入了2010年12月至2015年4月接受手术的26例患者。通过分离武林格氏隔和与内侧蒂连续的下蒂来进行缩小术,以保留对NAC及其附属乳腺实质的神经血管供应。该蒂被称为隔-下-内侧蒂。文中介绍了纳入标准、标记和规划以及详细的手术过程描述。 结果:总体满意度较高。80%的患者对其结果进行了评分。结果如下:81%评为“非常满意”;19%评为“有些满意”。在所有时间点,包括术后即刻,所有病例的NAC感觉均完好。 结论:联合蒂技术为乳头乳晕复合体提供了完整的神经血管来源。使用该蒂进行缩小术是一种安全的手术。由于该蒂的灵活性,巨大乳房的重塑可以不受任何限制地完成。早期结果很有前景,但需要评估长期结果。 证据水平IV:本刊要求作者为每篇文章指定证据水平。有关这些循证医学评级的完整描述,请参阅目录或作者在线指南www.springer.com/00266 。
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