From Plastic and Reconstructive Microsurgery, Careggi University Hospital.
Plast Reconstr Surg. 2024 Jun 1;153(6):1231-1238. doi: 10.1097/PRS.0000000000010838. Epub 2023 Jun 19.
A multitude of variants of tuberous breast exist, and a reconstructive algorithm could help in assessment of all features that affect the breast and planning the most appropriate surgical correction strategy. Although several efficient techniques have been described in the literature, the authors propose their experience to help standardize a diagnostic and therapeutic approach. The aim of this article is to assess the pathologic hallmarks of each type of tuberous breast and to propose a one-step reconstructive algorithm tailored to the patient characteristics based on the use of three different adipo-glandular flaps.
From September of 2006 to December of 2019, 118 patients were treated for tuberous breast in a one-step procedure using tailored local flaps according to the preoperatively assessed clinical variant. Minimum follow-up was 12 months. All the procedures were performed under local anesthesia.
A total of 220 tuberous breasts (98 hypoplastic and 122 normoplastic) were treated. Mean patient age was 20.2 years. Mean follow-up was 36.5 months. Six minor complications (capsular contracture and nipple-areola complex hypesthesia) but no major complications were reported. In 9% of cases, minor secondary procedures, including lipofilling, scar revisions, and breast implant substitution, were performed.
The proposed algorithm, including a comprehensive classification, preoperative planning, and surgical approach derived from the authors' experience, presents a tailored surgical approach for each type of tuberous breast.
CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, IV.
存在多种类型的乳房畸形，一种重建算法可以帮助评估所有影响乳房的特征，并制定最合适的手术矫正策略。尽管文献中已经描述了几种有效的技术，但作者提出了自己的经验，以帮助标准化诊断和治疗方法。本文旨在评估每种类型乳房畸形的病理特征，并根据使用三种不同的脂肪-腺体皮瓣，为每位患者量身定制一步式重建算法。
自 2006 年 9 月至 2019 年 12 月，根据术前评估的临床变异类型，采用个体化局部皮瓣对 118 例乳房畸形患者进行了一步法治疗。所有手术均在局部麻醉下进行。
共治疗了 220 例乳房畸形（98 例乳房过小和 122 例乳房正常）。患者平均年龄为 20.2 岁。平均随访时间为 36.5 个月。报告了 6 例轻微并发症（包膜挛缩和乳头乳晕复合体感觉迟钝），但无严重并发症。9%的患者进行了轻微的二次手术，包括脂肪填充、疤痕修整和乳房植入物置换。
所提出的算法，包括全面的分类、术前规划和手术方法，是根据作者的经验衍生而来的，为每种类型的乳房畸形提供了量身定制的手术方法。
临床问题/证据水平：治疗性，IV。
