Schwartz Jean-Claude D, Skowronksi Piotr P
Georgia Breast Surgery, PC, Lawrenceville, Ga.; and Georgia Plastic Surgery and Reconstructive Care, PC, Monroe, Ga.
Plast Reconstr Surg Glob Open. 2017 Mar 8;5(3):e1259. doi: 10.1097/GOX.0000000000001259. eCollection 2017 Mar.
Nipple-sparing mastectomy (NSM) is challenging in patients with significant ptosis and skin excess. We previously described the first use of a surgical delay (a supraareolar incision with undermining off the breast mound) to facilitate a second-stage pedicled NSM and reconstruction. Here, we present an improvement in our surgical delay technique-a total skin and NSM through Wise incisions. This technique obviates concerns regarding delays in cancer care and more aggressively delays the nipple, allowing for more reliable and extreme NAC transpositions. This strategy also delays the Wise pattern flaps resulting in better wound healing, which is critical in implant-based reconstructions.
对于有明显乳房下垂和皮肤过多的患者，保留乳头的乳房切除术（NSM）具有挑战性。我们之前描述了首次使用手术延迟（乳晕上切口并在乳房隆起处进行皮下分离）来促进二期带蒂NSM和重建。在此，我们展示了手术延迟技术的一项改进——通过 Wise 切口进行全皮肤和 NSM。该技术消除了对癌症治疗延迟的担忧，并更积极地延迟乳头，从而实现更可靠和更极端的乳头乳晕复合体（NAC）移位。这种策略还延迟了 Wise 模式皮瓣，从而实现更好的伤口愈合，这在基于植入物的重建中至关重要。
