Serra-Mestre José Maria, Fernandez Peñuela Randolfo, Foti Vanessa, D'Andrea Francesco, Serra-Renom José Maria
Barcelona, Spain; and Naples, Italy.
From the Aesthetic, Plastic and Reconstructive Surgery Department, Hospital Quirón Barcelona; Universitat Internacional de Catalunya; and the Plastic and Reconstructive Surgery Department, University of Naples Federico II.
Plast Reconstr Surg. 2017 Nov;140(5):665e-672e. doi: 10.1097/PRS.0000000000003788.
In their descriptions of the ideal breast, most studies have focused primarily on the dimensions, shape, and proportions. The distance between the breasts has only very rarely been considered. The intermammary distance and the medial symmetry between the breasts are important parts of the outcome of surgery and have a strong bearing on patient satisfaction. However, the control surgeons have over these factors is only relative, and depends heavily on the underlying anatomical characteristics of the patients.
Eighty-six patients undergoing breast augmentation, breast reduction, or mastopexy and breast reconstruction with separated or asymmetric breasts underwent fat grafting in the medial quadrants. Intermammary distances were measured before fat grafting and 12 months later. Complications were also recorded.
This technique obtained a statistically significant reduction in the mean intermammary distance (p < 0.0001) from 3 ± 0.6 cm (range, 1.6 to 5 cm) to 1.7 ± 0.4 cm (range, 1 to 2.8 cm) at 12-month follow-up. There were no major complications: one capsular contracture in a breast reconstruction requiring capsulotomy and an oil cyst requiring aspiration were reported.
The authors' technique allows safe remodeling of the medial cleavage of the breast, reducing the intermammary distance and optimizing the symmetry between the breasts.
CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, IV.
在对理想乳房的描述中，大多数研究主要集中在尺寸、形状和比例上。乳房间距很少被考虑。乳房间距离和乳房内侧对称性是手术结果的重要组成部分，对患者满意度有很大影响。然而，外科医生对这些因素的控制只是相对的，很大程度上取决于患者的基础解剖特征。
86例接受隆乳、缩乳、乳房上提术或乳房重建且乳房分离或不对称的患者在内侧象限进行了脂肪移植。在脂肪移植前和12个月后测量乳房间距离。还记录了并发症情况。
该技术在12个月随访时使平均乳房间距离从3±0.6厘米（范围1.6至5厘米）显著降低至1.7±0.4厘米（范围1至2.8厘米）（p<0.0001）。未出现重大并发症：报告了1例乳房重建中需要进行包膜切开术的包膜挛缩和1例需要抽吸的油囊肿。
作者的技术可安全重塑乳房内侧间隙，缩小乳房间距离并优化乳房对称性。
临床问题/证据水平：治疗性，IV级。
