Ors Safvet
SO-EP Aesthetic and Plastic Surgery Clinic, Seyitgazi Mah. Seyyid Burhaneddin Bulv. No: 51/A, 38050, Kayseri, Turkey.
Aesthetic Plast Surg. 2018 Feb;42(1):88-97. doi: 10.1007/s00266-017-0987-8. Epub 2017 Oct 26.
Several factors, such as aging, pregnancy, and weight loss, reduce the elasticity of the breast tissue, and ptosis occurs. Due to aging and gravity, it is not possible to completely prevent breast ptosis. The goal is to delay the recurrence of ptosis as much as possible.
This study included 20 female patients aged 25-55 years. The patients who underwent surgery had different levels of ptosis. Although the patients wanted their breasts to be lifted and an increase in projection, they did not want implants to be used. For this reason, autologous flaps were prepared from the patients, and these flaps were called autoprosthesis flaps. The flap donor area (FA) boundaries consisted of the inframammary fold at the bottom, the medial and lateral pillar legs at the two sides and the lower margin of the areola at the top. The skin on the FA was de-epithelialized. A hand dermatome was used to ensure that the extracted skin was not too thick because the rest of the dermal skin would form the cover of the planned autoprosthesis flap. Before surgery, the autoprosthesis flap baseline width, projection, and shape (round or anatomic) were planned for each patient. The autoprosthesis flap was prepared as a central pedicle, and the dermal layer, which was 1 cm wider than the flap, was then attached over the autoprosthesis flap to the pectoral muscle fascia with at least 10 sutures in the recipient area. For a round autoprosthesis flap, the flap base diameter was 10-12 cm on average, whereas for an anatomic autoprosthesis flap, the width of the flap was 10-12 cm and the height was 12-14 cm. Autoprosthesis flap projections varied from 4 to 6 cm.
Because of the autoprosthesis flap, breast projection was more prominent, even in the lying position. All the patients were very satisfied with their size, shape, projection, and natural appearance. In particular, the image in the lying position was very similar to a mastopexy performed with an actual breast implant; thus, sagging was not observed.
In augmentation mastopexy patients who do not want implants, upper pole filling and adequate breast projection can be easily achieved with this method. The potential risks of capsule formation, implant rejection, and implant rupture were not observed with this technique.
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衰老、怀孕和体重减轻等多种因素会降低乳房组织的弹性，进而导致乳房下垂。由于衰老和重力作用，完全预防乳房下垂是不可能的。目标是尽可能延缓下垂的复发。
本研究纳入了20名年龄在25至55岁之间的女性患者。接受手术的患者乳房下垂程度各异。尽管患者希望提升乳房并增加凸度，但不希望使用植入物。因此，从患者自身制备皮瓣，这些皮瓣被称为自体假体皮瓣。皮瓣供区（FA）边界由底部的乳房下皱襞、两侧的内侧和外侧柱状腿以及顶部乳晕的下缘组成。对FA上的皮肤进行去上皮处理。使用手动取皮刀以确保提取的皮肤不过厚，因为其余的真皮皮肤将形成计划中的自体假体皮瓣的覆盖层。术前，为每位患者规划自体假体皮瓣的基线宽度、凸度和形状（圆形或解剖形）。自体假体皮瓣制备为中央蒂型，然后将比皮瓣宽1 cm的真皮层在受体区域用至少10针缝线覆盖在自体假体皮瓣上并固定于胸肌筋膜。对于圆形自体假体皮瓣，皮瓣基部直径平均为10至12 cm，而对于解剖形自体假体皮瓣，皮瓣宽度为10至12 cm，高度为12至14 cm。自体假体皮瓣的凸度在4至6 cm之间。
由于使用了自体假体皮瓣，即使在卧位时乳房凸度也更显著。所有患者对其大小、形状、凸度和自然外观都非常满意。特别是卧位时的外观与使用实际乳房植入物进行乳房上提术后非常相似；因此，未观察到下垂现象。
在不希望使用植入物的隆乳上提术患者中，采用这种方法可以轻松实现上极填充和足够的乳房凸度。该技术未观察到包膜形成、植入物排斥和植入物破裂等潜在风险。
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