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采用上蒂法行垂直瘢痕缩小乳房成形术后成功进行母乳喂养:1例病例报告。

A successful breastfeeding after vertical scar reduction mammaplasty with superior pedicle: A case report.

作者信息

Seswandhana Rosadi, Anzhari Sharfan, Dachlan Ishandono

机构信息

Division of Plastic, Reconstructive and Aesthetic Surgery, Department of Surgery, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada/Dr. Sardjito Hospital, Yogyakarta, Indonesia.

出版信息

Ann Med Surg (Lond). 2020 Nov 22;60:600-603. doi: 10.1016/j.amsu.2020.11.049. eCollection 2020 Dec.

Abstract

INTRODUCTION

Most of patients undergo reduction mammaplasty for aesthetic or therapeutic reasons without consider the effect on breastfeeding function. Vertical scar mammaplasty with superior pedicle is expected to be a breast reduction procedure that can keep maintain the function of breastfeeding. This is the first recorded report of breastfeeding after vertical scar reduction mammaplasty with superior pedicle in Indonesia.

PRESENTATION OF CASE

A 23 years old woman presented to the outpatient clinic with enlargement of both breast for 3 years. Physical examination showed bilateral breast enlargement. No tenderness, nodules, nor axillary lymph node enlargement were found. The patient was managed with vertical scar mammaplasty with superior pedicle. The patient was followed up with complication of skin excess and scarring on the bilateral submammary folds. We performed excision and resection procedures to eliminate the skin excess and scars without further complications. The patient was married and gave birth to her first and second child after two and five years following mammaplasty. The patient was able to provide exclusive breastfeeding for both of her children.

DISCUSSION

Vertical scar mammaplasty with superior pedicle surgery is a surgical technique that combines a superior pedicle for the areola and performs a central-inferior quadrant resection for breast reduction. It only takes the tissue and glands that are located in the lower quadrant and still maintains the surrounding tissue and glands. This technique also maintains the integrity of nipple-areola complex (NAC) which also important in the lactation process.

CONCLUSION

Vertical scar mammaplasty with superior pedicle can be one of the superior techniques in breast reduction which can maintain the breastfeeding function thereby increasing patient satisfaction.

摘要

引言

大多数患者因审美或治疗原因接受乳房缩小术,而未考虑对母乳喂养功能的影响。带蒂上蒂垂直瘢痕乳房缩小术有望成为一种能够保留母乳喂养功能的乳房缩小手术。这是印度尼西亚首例关于带蒂上蒂垂直瘢痕乳房缩小术后母乳喂养的报道。

病例介绍

一名23岁女性因双侧乳房增大3年就诊于门诊。体格检查显示双侧乳房增大。未发现压痛、结节或腋窝淋巴结肿大。该患者接受了带蒂上蒂垂直瘢痕乳房缩小术。患者随访时出现双侧乳房下皱襞皮肤过多和瘢痕形成的并发症。我们进行了切除和修复手术以消除皮肤过多和瘢痕,未出现进一步并发症。该患者婚后在乳房缩小术后两年和五年分别生下第一胎和第二胎。患者能够纯母乳喂养两个孩子。

讨论

带蒂上蒂垂直瘢痕乳房缩小术是一种手术技术,它采用乳晕上蒂并对乳房下象限进行中央-下象限切除以缩小乳房。它仅切除位于下象限的组织和腺体,同时保留周围的组织和腺体。该技术还保持了乳头乳晕复合体(NAC)的完整性,这在泌乳过程中也很重要。

结论

带蒂上蒂垂直瘢痕乳房缩小术可以是乳房缩小术中的一种较好技术,它能够保留母乳喂养功能,从而提高患者满意度。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c089/7708693/231f6a2ee91e/gr1.jpg

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