Go Ju Young, Jeong Dae Kyun, Han Daniel Seungyoul, Bae Seong Hwan
DH Plastic Surgery, Busan, Korea.
Department of Plastic and Reconstructive Surgery, Pusan National University School of Medicine, Busan, Korea.
Plast Reconstr Surg Glob Open. 2018 Dec 17;6(12):e2052. doi: 10.1097/GOX.0000000000002052. eCollection 2018 Dec.
When we perform a breast augmentation through the inframammary fold (IMF) approach, incision placement at the new IMF is a key element of the planning process. In the majority of the previously published methods, the new IMF was planned based on the nipple-areola complex (NAC) position. However, these methods can lead to asymmetry in the IMF if the NAC is not symmetrical.
We present the IMF flap excision method for correction of asymmetries of NAC and IMF. The new IMF position was marked based on the ICE technique. We have redesigned the higher side IMF to the same height as the lower side. And then we removed the amount of the skin and soft tissue, which corresponded to the difference between the 2 IMF. We dissected the submuscular breast pocket higher than in the usual cases, making it easier to move the breast tissue downward.
This method was performed on 21 patients, with an average follow-up time of 6 months (range, 2-9 months). The average correction amount of asymmetry of the NAC ranged from 3 to 15 mm and was maintained throughout the follow-up period. NAC downward positioning and symmetry of IMF were observed. Almost all patients showed improvement or complete resolution of their nipple asymmetry.
The IMF flap excision method corrected the asymmetries in the NAC and IMF without additional scars. This method should be strongly considered in patients undergoing a primary breast augmentation procedure with mild NAC asymmetry.
当我们通过乳房下皱襞（IMF）入路进行隆胸手术时，在新的乳房下皱襞处放置切口是手术规划过程中的关键要素。在大多数已发表的方法中，新的乳房下皱襞是根据乳头乳晕复合体（NAC）的位置来规划的。然而，如果乳头乳晕复合体不对称，这些方法可能会导致乳房下皱襞不对称。
我们提出了用于矫正乳头乳晕复合体和乳房下皱襞不对称的乳房下皱襞皮瓣切除法。基于ICE技术标记新的乳房下皱襞位置。我们将较高一侧的乳房下皱襞重新设计到与较低一侧相同的高度。然后切除与两侧乳房下皱襞差异相对应的皮肤和软组织量。我们在比通常情况更高的位置解剖胸大肌下乳房腔隙，使乳房组织更容易向下移动。
该方法应用于21例患者，平均随访时间为6个月（范围2 - 9个月）。乳头乳晕复合体不对称的平均矫正量为3至15毫米，且在整个随访期间保持稳定。观察到乳头乳晕复合体向下定位以及乳房下皱襞对称。几乎所有患者的乳头不对称情况都有改善或完全解决。
乳房下皱襞皮瓣切除法矫正了乳头乳晕复合体和乳房下皱襞的不对称，且无额外瘢痕。对于初次隆胸手术且乳头乳晕复合体轻度不对称的患者，应强烈考虑采用该方法。
