Rammos Charalambos K, Mammolito Denise, King Victor A, Yoo Aran
Division of Plastic and Reconstructive Surgery, University of Illinois College of Medicine at Peoria, Peoria, Ill.
Plast Reconstr Surg Glob Open. 2018 Jul 12;6(7):e1853. doi: 10.1097/GOX.0000000000001853. eCollection 2018 Jul.
Wise pattern skin reduction mastectomy with prepectoral placement of the device is a recent technique for reconstruction in patients with large and ptotic breasts. Expanders in the first stage, followed by implant exchange in the second stage are placed above the pectoralis major muscle, totally covered by acellular dermal matrix and an inferior dermal flap. This technique was performed on 6 breasts in 4 obese patients with macromastia and grade 2 and 3 ptosis. Two patients experienced complications at the T-junction. One patient experienced superficial skin sloughing managed conservatively. The second patient developed full-thickness necrosis treated with excision and primary closure. No implant loss occurred. All patients were exchanged in a second stage to an implant, and 2 of them had symmetry procedures, with good cosmetic results. Larger, long-term studies are required to further characterize results and define the limitations of this newer surgical technique.
采用胸肌前放置装置的明智模式皮肤缩减乳房切除术是一种用于大而下垂乳房患者重建的最新技术。第一阶段放置扩张器，第二阶段进行植入物置换，扩张器和植入物置于胸大肌上方，完全由脱细胞真皮基质和下方皮瓣覆盖。该技术应用于4例患有巨乳症且伴有2级和3级下垂的肥胖患者的6个乳房。2例患者在T形交界处出现并发症。1例患者发生浅表皮肤脱落，采取保守治疗。第2例患者出现全层坏死，经切除和一期缝合治疗。未发生植入物丢失。所有患者在第二阶段均更换为植入物，其中2例进行了对称手术，美容效果良好。需要进行更大规模的长期研究，以进一步明确结果并界定这种新手术技术的局限性。
