Post-Graduate Course of Plastic Surgery of the ACA - Institute of Assistance in Plastic Surgery of São Paulo, Division of Plastic Surgery at General Hospital São Rafael, Brazilian Society of Plastic Surgery and Brazilian Medical Association, Rua Afonso de Freitas 641, São Paulo, SP, 04006-052, Brazil.
Aesthetic Plast Surg. 2019 Jun;43(3):584-590. doi: 10.1007/s00266-019-01337-1. Epub 2019 Mar 6.
Mastopexy autoaugmentation by using an extended vertical flap and two transverse triangular flaps of mammary parenchyma was performed through an adjustable vertical ice cream cone-shaped approach.
A vertical rectangular flap with the length of the inferior pole and thickness of the mammary parenchyma was supported at the inframammary fold. Dissection of the vertical flap was extended underneath the areola until the projection of its upper limit, adding 4-5 cm to the length of the vertical flap. A triangular flap supported on its lower half with 4-6 cm long and thickness of the vertical pillar was dissected on both vertical pillars. Patients were followed up for 2 years.
The vertical rectangular flap filled the upper pole and central breast. The triangular flaps apart from filling the lower pole increased the mammary cone projection. The medial rotation advancement of the triangular flaps created a transverse support girdle at the lower pole, maintaining the vertical flap into position. In addition, fixation of the vertical flap along its entire length avoided long-term down-displacement of the breast. A keel resection of mammary parenchyma was performed in the larger breast in mild or moderate asymmetries.
Mastopexy autoaugmentation through an adjustable vertical approach using vertical and triangular flaps of mammary parenchyma filled the upper pole and central breast and reshape the lower pole, recovering the breast contour. It provided long-term stabilization of the mammary cone without a breast implant or fat transfer.
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通过采用扩展的垂直皮瓣和两个横向三角形乳房实质瓣，使用可调式垂直冰淇淋锥形入路进行乳房提升自体脂肪填充。
在乳晕下方支撑一个具有下极长度和乳房实质厚度的垂直矩形皮瓣。垂直皮瓣的解剖向下延伸至乳晕下方，直到其上限的投影，使垂直皮瓣的长度增加 4-5cm。在两个垂直支柱上，以 4-6cm 长和垂直支柱厚度支撑的三角形皮瓣进行解剖。患者随访 2 年。
垂直矩形皮瓣填充了上极和中央乳房。除了填充下极外，三角形皮瓣还增加了乳房圆锥体的突出度。三角形皮瓣的内侧旋转推进在下极处形成了一个横向支撑带，使垂直皮瓣保持在原位。此外，垂直皮瓣的全长固定避免了乳房的长期向下移位。在轻度或中度不对称的较大乳房中，进行了乳房实质的龙骨切除术。
通过使用垂直和三角形乳房实质皮瓣的可调式垂直入路进行乳房提升自体脂肪填充，填充了上极和中央乳房，并重塑了下极，恢复了乳房轮廓。它提供了乳房圆锥体的长期稳定，无需乳房植入物或脂肪转移。
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