Ter Louw Ryan P, Bruce Sara B, Nahabedian Maurice Y
Department of Plastic Surgery, Georgetown University Hospital, Wash.; and Department of Surgery, Fairfax Virginia Inova Fairfax Hospital, Falls Church, Va.
Plast Reconstr Surg Glob Open. 2017 Jan 25;5(1):e1200. doi: 10.1097/GOX.0000000000001200. eCollection 2017 Jan.
Giant juvenile fibroadenomas are relatively rare, accounting for less than 1% fibroadenomas. Large breast tumors create significant asymmetry and provide unique reconstructive challenges after removal. In this case, we describe a 21-year-old female with delayed presentation of a giant fibroadenoma of the right breast. This represents an unusual presentation of benign breast disease requiring reduction of the skin envelope, extensive glandular resection, lower pole reconstruction, and free nipple grafting to achieve symmetry with the opposite breast. A novel modification of the Goldilocks mastectomy technique is described for partial breast reconstruction. Adaptation of the Goldilocks mastectomy technique provides adequate soft tissue for partial breast reconstruction. Using the lower pole deepithelialization breast skin flap provides autologous vascularized tissue to supplement volume loss after tumor and glandular excision. Benign breast disease can create significant breast deformities. Application and combination of the Goldilocks mastectomy technique allow for partial breast reconstruction without the need for an additional donor site or prosthetic devices.
巨大型青少年纤维腺瘤相对罕见，占纤维腺瘤的比例不到1%。巨大的乳腺肿瘤会造成明显的不对称，切除后会带来独特的重建挑战。在此病例中，我们描述了一名21岁女性，其右侧乳腺巨大纤维腺瘤出现延迟。这是一种不常见的良性乳腺疾病表现，需要缩小皮肤包膜、广泛切除腺体组织、进行下极重建以及游离乳头移植，以实现与对侧乳房对称。本文描述了一种对“金发姑娘”乳房切除术技术的新颖改良方法用于部分乳房重建。采用“金发姑娘”乳房切除术技术可提供足够的软组织用于部分乳房重建。使用下极去上皮化乳房皮瓣可提供自体带血管组织，以补充肿瘤和腺体切除后的体积损失。良性乳腺疾病可导致明显的乳房畸形。“金发姑娘”乳房切除术技术的应用和联合使用，使得无需额外的供区或假体装置即可进行部分乳房重建。
