Smithson Mary G, Collawn Sherry S, Mousa Mina S, Bramel Carly M
From the *UAB School of Medicine, Plastic Surgery, †UAB Division of Plastic Surgery/Department of Surgery, Birmingham, AL; ‡University of South Florida Morsani College of Medicine, Tampa, FL; and §University of Alabama School of Health Professions, Birmingham, AL.
Ann Plast Surg. 2017 Jun;78(6S Suppl 5):S343-S346. doi: 10.1097/SAP.0000000000001038.
For women with macromastia, reduction mammoplasty is a safe and effective solution to increasing quality of life through alleviating pain and improving aesthetics. This study developed a way to combine a surgeon's view of breast measurement (volume) with a patient's view of breast measurement (distance between nipple and notch, inframammary fold, or midline) to provide patients with a better understanding of expected surgical outcomes after breast reduction with a medial superior pedicle.
An institutional review board approved retrospective chart review was performed on all medial superior pedicle reduction mammoplasties performed by a single surgeon at a university medical center from 2008 to 2016, and a total of 133 patients were identified. Measurements of interest for this study were nipple to sternal notch (N-S), nipple to inframammary fold (N-I), nipple to midline (N-M), and breast diameter (BD). The average bilateral change per measurement was calculated for each patient in centimeters. Change was averaged for left and right breasts for N-S, N-I, N-M, and BD per patient. Grams removed for left and right breasts were also averaged. Each measurement of average change was divided by the gram average and multiplied by 100 to obtain centimeter change per 100 grams. Individual patient measurements per type of measurement were averaged to achieve a final improvement reported in centimeters per 100 g tissue removed per breast.
The average change in the N-S distance was calculated to be a decrease of 1.5 ± 0.8 cm/100 g of breast tissue removed. The average change in N-I was calculated to be an overall decrease of 0.7 ± 0.5 cm/100 g. The average change in N-M was calculated to be a decrease of 0.1 ± 0.3 cm/100 g. Finally, the average change in BD was calculated to be 0.0 ± 0.4 cm/100 g.
A surgeon's expression of breast measurements in terms of volume can be difficult for a patient to understand and visualize. This study determined the impact volume has on length of typical breast measurements to increase patients' understanding of expected outcomes. In summary, patients can be told to expect to see a nipple elevation of 1.5 cm per 100 grams of breast tissue removed using this medial superior pedicle technique.
对于巨乳症女性而言，缩乳术是一种安全有效的解决方案，可通过缓解疼痛和改善美观来提高生活质量。本研究开发了一种方法，将外科医生对乳房测量（体积）的观点与患者对乳房测量（乳头与胸骨切迹、乳房下皱襞或中线之间的距离）的观点相结合，以便让患者更好地了解采用内侧上蒂法进行缩乳术后的预期手术效果。
对一所大学医学中心的一位外科医生在2008年至2016年期间进行的所有内侧上蒂缩乳术进行了机构审查委员会批准的回顾性病历审查，共确定了133例患者。本研究感兴趣的测量指标为乳头至胸骨切迹（N-S）、乳头至乳房下皱襞（N-I）、乳头至中线（N-M）以及乳房直径（BD）。计算每位患者每项测量指标的平均双侧变化量，单位为厘米。每位患者的N-S、N-I、N-M和BD的左右乳房变化量取平均值。左右乳房切除的克数也取平均值。将每项平均变化量的测量值除以克数平均值，再乘以100，以获得每100克的厘米变化量。对每种测量类型的个体患者测量值取平均值，以得出每侧乳房每切除100克组织时以厘米为单位报告的最终改善情况。
计算得出N-S距离的平均变化量为每切除100克乳房组织减少1.5±0.8厘米。N-I的平均变化量计算得出总体减少0.7±0.5厘米/100克。N-M的平均变化量计算得出减少0.1±0.3厘米/100克。最后，BD的平均变化量计算得出为0.0±0.4厘米/100克。
外科医生以体积来表达乳房测量值可能让患者难以理解和想象。本研究确定了体积对典型乳房测量长度的影响，以增强患者对预期结果的理解。总之，可以告知患者，采用这种内侧上蒂技术，每切除100克乳房组织，乳头预计会抬高1.5厘米。
