Department of Plastic Surgery and Burns Treatment, Copenhagen University Hospital, Rigshospitalet Blegdamsvej 9, DK-2100, Copenhagen, Denmark.
Amalieklinikken, Dronningens Tværgade 30, DK-1302, Copenhagen, Denmark.
Aesthetic Plast Surg. 2021 Apr;45(2):423-430. doi: 10.1007/s00266-020-02028-y. Epub 2020 Oct 28.
Most surgeons choose to de-epithelialize when performing a mastopexy to minimize the risk of nipple-areola-complex (NAC) necrosis. Preservation of the dermis and thus the subdermal plexus is thought to be crucial for the survival of the NAC. However, this has never been scientifically proven. Deskinning involves resection of the epidermis and the dermis and is a timesaving alternative to de-epithelialization. In this study, we present data from mastopexy patients with or without implant surgery with total deskinning of the Wise pattern.
From September 2012 to March 2020, a single surgeon performed all inverted-T mastopexies using the deskinning technique. The patients were included retrospectively, and data were collected by reviewing the patients' medical records with emphasis on NAC necrosis.
The cohort consisted of 274 consecutive patients who underwent bilateral mastopexy. Of these, 134 patients underwent mastopexy as the only procedure and 140 patients underwent mastopexy in combination with implant surgery. The median follow-up was 29 months (IQR 13-40 months). No complete NAC-necrosis occurred. Unilateral, partial NAC necrosis occurred in three patients who underwent mastopexy in combination with implant surgery.
The NAC necrosis rate following inverted-T mastopexy using the deskinning technique is comparable to the rate of NAC-necrosis reported in the literature following mastopexy using the de-epithelialization technique. Our findings support that the use of deskinning is a safe and time-efficient method for patients undergoing inverted-T mastopexy.
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大多数外科医生在进行乳房上提术时选择去表皮化以最大程度降低乳头乳晕复合体（NAC）坏死的风险。保留真皮和皮下丛被认为对 NAC 的存活至关重要。然而，这从未得到科学证明。去表皮化涉及表皮和真皮的切除，是替代去上皮化的省时方法。在这项研究中，我们报告了采用全 Wise 皮瓣去皮术的乳房上提术患者的数据，这些患者接受或未接受植入物手术。
从 2012 年 9 月至 2020 年 3 月，一位外科医生使用去皮技术对所有倒 T 乳房上提术进行了手术。回顾性纳入患者，通过查阅患者病历收集数据，重点关注 NAC 坏死。
该队列包括 274 例连续双侧乳房上提术患者。其中，134 例患者仅行乳房上提术，140 例患者行乳房上提术联合植入物手术。中位随访时间为 29 个月（IQR 13-40 个月）。无完全 NAC 坏死发生。3 例接受乳房上提术联合植入物手术的患者发生单侧、部分 NAC 坏死。
使用去皮技术行倒 T 乳房上提术的 NAC 坏死率与文献中报道的行去上皮化技术乳房上提术的 NAC 坏死率相当。我们的研究结果支持，对于接受倒 T 乳房上提术的患者，使用去皮术是一种安全且省时的方法。
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