Department of Surgery, Damsoyu Hospital, 234 Hakdong-ro, Gangnam-gu, Seoul, Republic of Korea.
Aesthetic Plast Surg. 2020 Jun;44(3):677-686. doi: 10.1007/s00266-020-01649-7. Epub 2020 Mar 4.
Symptoms of axillary accessory breasts (AABs) vary among patients. Mildly protruding AABs do not require skin excision, whereas severely protruding AABs might. We report a novel technique that includes mammary gland excision followed 6 months later by second-look redundant skin excision, if necessary.
We aimed to evaluate the efficacy of this two-step surgical approach and compared it with one-step en bloc resection in severely protruding AAB patients.
This retrospective study included 834 women who underwent AAB excision during 2017-2019. AABs were classified according to their external appearance: protruding, palpable accessory breast at an obtuse angle (class I) or an acute angle with accompanying skinfold (class II). Class II was further divided according to the excision technique: one-step en bloc resection (n = 36) or two-step resection (n = 42). Patients completed post hoc satisfaction surveys evaluating appearance, axillary pain, and scar, 6 months postoperatively.
There were 204 class II patients and 168 patients who underwent a two-step approach; 42/168 underwent second-look skin excision, and 126/168 underwent one-step gland excision exclusively. The remaining 36 patients underwent one-step resection. Scars measured 4.3 cm in the second-look group versus 6.4 cm in the one-step group (P < 0.000). Overall satisfaction scores were higher in the second-look group versus the one-step group (13.6 vs. 12.3, respectively; P < 0.000).
For severely protruding AABs, mammary gland excision with skin preservation comprises the first operation, and second-look skin excision can be considered 6 months later. This procedure avoids overtreatment and potentially increases patient satisfaction compared with one-step en bloc excision.
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腋窝副乳腺（AAB）的症状在患者之间存在差异。轻度突出的 AAB 不需要切除皮肤，而严重突出的 AAB 可能需要。我们报告了一种新的技术，包括乳腺切除，6 个月后根据需要进行二次冗余皮肤切除。
我们旨在评估这种两步手术方法的疗效，并将其与严重突出的 AAB 患者的一步整块切除术进行比较。
这项回顾性研究纳入了 2017 年至 2019 年间接受 AAB 切除术的 834 名女性。根据外观将 AAB 分为：突出的、钝角可触及的副乳腺（I 类）或锐角伴有皮褶的副乳腺（II 类）。II 类根据切除技术进一步分为一步整块切除术（n=36）或两步切除术（n=42）。患者在术后 6 个月完成了关于外观、腋窝疼痛和疤痕的术后满意度调查。
有 204 例 II 类患者和 168 例接受两步法的患者；其中 42/168 例进行了二次皮肤切除，126/168 例仅进行了一步腺体切除，其余 36 例患者进行了一步切除。二次观察组的疤痕长度为 4.3cm，而一步组为 6.4cm（P<0.000）。二次观察组的总体满意度评分高于一步组（分别为 13.6 分和 12.3 分；P<0.000）。
对于严重突出的 AAB，保留皮肤的乳腺切除为第一手术，可在 6 个月后考虑进行二次皮肤切除。与一步整块切除术相比，这种方法避免了过度治疗，可能会提高患者的满意度。
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