Abdelkader Rasha, El-Noamany Sameh, Raafat Sarah
Department of Plastic Surgery, Faculty of Medicine, Cairo University, Cairo, Egypt.
Plast Reconstr Surg Glob Open. 2021 Jun 22;9(6):e3640. doi: 10.1097/GOX.0000000000003640. eCollection 2021 Jun.
Although a boxy breast is a common aesthetic problem following breast reduction and mastopexy, literature regarding this deformity is scarce. It is vaguely described as a definitive postreduction deformity. To address this complication, it is important to fully analyze the problem, understand and predict its causes, and then try to prevent it.
This study included two groups. Group 1 included 14 patients presenting with boxy postoperative breasts. Revision surgeries were conducted for all patients, and the first algorithm was created for quantifying breast surgery in revision cases. Group 2 included 37 cases of primary mammaplasty reduction/mastopexy performed between 2016 and 2019. All the patients in this group were treated as per the study algorithm.
Patient satisfaction was measured on a scale of one to 10, with one being extremely dissatisfied and 10 being extremely satisfied. The results indicated overall satisfaction, with average scores of 9.5 and 9.1 in groups 1 and 2, respectively; the scores of surgeon satisfaction were 8.2 and 8.6, respectively.
The proposed algorithm, preoperative markings, intraoperative techniques, and postoperative orientation may help achieve optimal results and prevent undesired deformities or asymmetry. Applying a flexible and simplified algorithm provided a more objective plan, which enabled surgeons to attain more satisfactory results. Following a preset quantified plan supported and shortened learning curves and objectively addressed the common postoperative complication, breast boxing.
尽管方形乳房是乳房缩小术和乳房上提术后常见的美学问题，但关于这种畸形的文献却很稀少。它被模糊地描述为一种明确的术后畸形。为了解决这一并发症，全面分析问题、理解并预测其原因，然后设法预防是很重要的。
本研究包括两组。第一组包括14例术后乳房呈方形的患者。对所有患者进行了修复手术，并创建了第一个算法来量化修复病例中的乳房手术。第二组包括2016年至2019年间进行的37例原发性乳房缩小/乳房上提术病例。该组所有患者均按照研究算法进行治疗。
患者满意度采用1至10分制进行衡量，1分为极度不满意，10分为极度满意。结果显示总体满意度较高，第一组和第二组的平均得分分别为9.5分和9.1分；外科医生满意度得分分别为8.2分和8.6分。
所提出的算法、术前标记、术中技术和术后指导可能有助于获得最佳效果，并防止出现不良畸形或不对称。应用灵活且简化的算法提供了更客观的方案，使外科医生能够获得更满意的结果。遵循预设的量化方案有助于支持并缩短学习曲线，客观地解决常见的术后并发症——乳房方形畸形问题。
