Hunt Sarah C, Sun Yue, Azad Sanjay
Northern Ontario School of Medicine, Thunder Bay, ON, Canada.
Aesthet Surg J Open Forum. 2022 Apr 1;4:ojac019. doi: 10.1093/asjof/ojac019. eCollection 2022.
Breast reduction is a common procedure for plastic surgery. The authors have adopted a modified technique using the medial pedicle, with markings using a 15-9-9 framework and a methodical step-wise approach.
This study introduces the 15-9-9 framework as a design for medial pedicle breast reductions that is easy to perform and teach, with favorable outcomes.
Markings using the 15-9-9 framework were used, describing the mosque dome and medial pedicle length and width. The technique was performed in day surgery under general anesthesia. Patients were followed up for 1 year, with photographs taken at each visit and complications recorded. A retrospective review of 80 patients between November 2013 and July 2019 was completed in a single-surgeon's practice.
Patients were an average of 49 years (18-72 years) with a BMI of 28 kg/m (23-32). The average planned postoperative sternal notch to areola distance was 22 cm (19-26 cm) and sternal notch to nipple distance was 24 cm (21-28 cm). The average duration of the surgical procedure was 3.4 hours. An average of 464 g (90-1210 g) was removed from each breast. Complication rates were low with minor fat necrosis (14%), T-junction breakdown (10%), hematoma (3.8%), dog ear formation (3.8%), junctional necrosis (2.5%), and partial nipple loss (1.3%). One patient had a cerebrovascular accident in the late postoperative period. Aesthetically pleasing results were achieved postoperatively.
This technique using the 15-9-9 framework is simple to learn, perform, and teach with overall aesthetically pleasing outcomes.
乳房缩小术是整形外科的常见手术。作者采用了一种改良技术，即使用内侧蒂，采用15 - 9 - 9框架进行标记，并采用有条不紊的逐步方法。
本研究介绍15 - 9 - 9框架作为内侧蒂乳房缩小术的一种设计，该设计易于实施和教授，且效果良好。
采用15 - 9 - 9框架进行标记，描述清真寺穹顶以及内侧蒂的长度和宽度。该技术在全身麻醉下的日间手术中进行。对患者进行了1年的随访，每次随访时拍照并记录并发症。在一位外科医生的实践中，对2013年11月至2019年7月期间的80例患者进行了回顾性研究。
患者平均年龄49岁（18 - 72岁），体重指数为28 kg/m（23 - 32）。计划术后胸骨切迹至乳晕的平均距离为22 cm（19 - 26 cm），胸骨切迹至乳头的平均距离为24 cm（21 - 28 cm）。手术平均时长为3.4小时。每侧乳房平均切除464 g（90 - 1210 g）。并发症发生率较低，轻微脂肪坏死（14%）、T形交界处破裂（10%）、血肿（3.8%）、狗耳形成（3.8%）、交界处坏死（2.5%）以及部分乳头缺失（1.3%）。1例患者在术后晚期发生脑血管意外。术后获得了美观的效果。
这种采用15 - 9 - 9框架的技术易于学习、实施和教授，总体效果美观。
