Swanson Eric
Swanson Center, Leawood, Kans.
Plast Reconstr Surg Glob Open. 2016 Dec 27;4(12):e1170. doi: 10.1097/GOX.0000000000001170. eCollection 2016 Dec.
The safety of augmentation mastopexy has been questioned. Staging has been recommended for women deemed to be at higher risk, such as women with greater degrees of ptosis. Most existing studies evaluate women treated with multiple methods, including the traditional Wise pattern. This retrospective study specifically evaluates vertical augmentation mastopexy. A simple algorithm is introduced.
From 2002 to 2016, 252 women underwent consecutive vertical augmentation mastopexies performed by the author, with no staged surgery. All patients underwent a vertical mastopexy using a medially based pedicle and intraoperative nipple siting. A subset of women treated from 2012 to 2016 were surveyed to obtain outcome data; 90 patients (inclusion rate, 90%) participated.
The complication rate was 32.9%, including persistent ptosis, delayed wound healing, scar deformities, and asymmetry. There were no cases of nipple loss. An increased risk of complications was detected for smokers ( < 0.01), but not for combined procedures, secondary breast augmentations, or secondary mastopexies. The revision rate was 15.5%. Persistent nipple numbness was reported by 13.3% of respondents. Eighty percent of women were self-conscious about their breast appearance before surgery; 22% of respondents were self-conscious about their breasts after surgery. Seventy percent of respondents reported an improved quality of life, 94.4% would repeat the surgery, and 95.6% would recommend it.
A simple algorithm may be used to guide treatment in women who desire correction of ptosis and upper pole fullness. An "all seasons" vertical augmentation mastopexy is safe and widely applicable. Staging is unnecessary.
隆乳上提术的安全性一直受到质疑。对于被认为风险较高的女性，如乳房下垂程度较重的女性，建议采用分期手术。大多数现有研究评估的是采用多种方法治疗的女性，包括传统的 Wise 术式。这项回顾性研究专门评估垂直隆乳上提术。并引入了一种简单的算法。
2002 年至 2016 年期间，252 名女性由作者连续进行了垂直隆乳上提术，未进行分期手术。所有患者均采用内侧蒂瓣垂直上提术及术中乳头定位。对 2012 年至 2016 年期间接受治疗的一部分女性进行了调查以获取结果数据；90 名患者（纳入率 90%）参与了调查。
并发症发生率为 32.9%，包括持续性乳房下垂、伤口愈合延迟、瘢痕畸形和不对称。没有乳头丢失的病例。吸烟者的并发症风险增加（<0.01），但联合手术、二期隆乳或二期上提术则没有这种情况。修复率为 15.5%。13.3%的受访者报告有持续性乳头麻木。80%的女性在手术前对自己的乳房外观感到难为情；22%的受访者在手术后对自己的乳房仍感到难为情。70%的受访者报告生活质量有所改善，94.4%的人愿意再次接受手术，95.6%的人会推荐该手术。
一种简单的算法可用于指导希望矫正乳房下垂和上极丰满度的女性的治疗。一种“四季通用”的垂直隆乳上提术是安全且广泛适用的。无需分期手术。
