Ioppolo Leonardo, Borelli Francesco, Alessandri Bonetti Mario, Amenta Antonio, Galati Marco, Veronesi Paolo, De Lorenzi Francesca
Marrelli Hospital, Via Gioacchino da Fiore 5, 88900, Crotone, Italy.
Department of Plastic and Reconstructive Surgery, European Institute of Oncology, IRCCS, Via Ripamonti 435, 20141, Milan, Italy.
Aesthetic Plast Surg. 2024 Nov;48(22):4656-4659. doi: 10.1007/s00266-024-04006-0. Epub 2024 Apr 2.
When planning for breast augmentation, it is important to consider not only implant choice, surgical technique and patient desires, but also the chest wall shape and deformities or irregularities, which remain often underestimated. They can be responsible for implant malposition and breast asymmetry after augmentation. Chondrocostal junction prominence is a minor but frequent chest wall deformity. The aim of this study is to report a new technique for sculpturing isolated chondrocostal prominence deformities in patients undergoing breast augmentation.
A retrospective study was conducted to review surgical outcomes of a novel technique for costal prominence sculpturing and reshaping in patients undergoing breast augmentation. After reaching the subpectoral space, an inferiorly-based perichondral-periosteal flap is harvested just above the prominence. Once the deformity is corrected, the perichondral flap is repositioned over the sculpted rib.
A total of six patients presenting with isolated chondrocostal prominence underwent bilateral breast implant placement and costal reduction using the described technique. Three patients were primary augmentations while the remaining patients were two secondary breast augmentation and one augmentation mastopexy. No complications were reported. No additional pain was referred at the side of rib remodelling in comparison with the contralateral breast. All the patients were satisfied with cosmetic results.
The described technique for contouring of isolated chondrocostal deformities is fast, easy reproducible and offers advantages over the standard partial rib reduction technique. It can prevent implant malposition and projection asymmetry, eventually enhancing breast augmentation outcomes.
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在计划隆胸手术时，不仅要考虑植入物的选择、手术技术和患者的期望，还要考虑胸壁的形状以及畸形或不规则情况，而这些往往被低估。它们可能导致隆胸后植入物位置不当和乳房不对称。肋软骨交界处突出是一种轻微但常见的胸壁畸形。本研究的目的是报告一种在隆胸患者中雕刻孤立性肋软骨突出畸形的新技术。
进行一项回顾性研究，以评估一种用于隆胸患者肋突出雕刻和重塑的新技术的手术效果。到达胸大肌下间隙后，在突出部位上方切取一个蒂在下方的软骨膜-骨膜瓣。畸形矫正后，将软骨膜瓣重新放置在雕刻后的肋骨上。
共有6例孤立性肋软骨突出患者采用所述技术进行了双侧乳房植入和肋骨缩小术。3例为初次隆胸，其余患者为2例二次隆胸和1例隆胸上提术。未报告并发症。与对侧乳房相比，肋骨重塑侧未出现额外疼痛。所有患者对美容效果均满意。
所述的孤立性肋软骨畸形塑形技术快速、易于重复，且优于标准的部分肋骨切除术。它可以防止植入物位置不当和突出不对称，最终提高隆胸效果。
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