Ma Xiaomu, Xu Boyang, Liu Wenyue, Li Shangshan, Liu Chunjun, Luan Jie
Chinese Academy of Medical Sciences, Peking Union Medical College, Plastic Surgery Hospital, No. 33 Badachu Road, Shijingshan District, Beijing, People's Republic of China.
Aesthetic Plast Surg. 2025 Jan;49(1):205-210. doi: 10.1007/s00266-024-04207-7. Epub 2024 Jul 16.
For females in puberty, mastectomy caused by pathological gigantomastia usually brings significant psychological problems. Appropriate immediate breast reconstruction method is necessary.
The aim of this study is to present a novel method of breast reconstruction that requires neither implants nor donor-site sacrifice.
All patients who were diagnosed with pathological gigantomastia and indicated for nipple-sparing or skin-sparing mastectomy (NSM or SSM) were selected. All extra skin was de-epithelialized, followed by NSM or SSM through a vertical incision on the lower pole of the breast. Then, a skin and dermal envelope in all directions was formed. Whether to preserve the nipple-areolar complex depended on its perfusion. The dermal flap was folded inward to serve as the "autologous dermal filler" and reconstruct the breast. A second surgery of inframammary fold elevation for larger projection was performed at least 6 months. Follow up for at least 1 year and record complications as well as pre- and postoperative BREAST-Q Scores.
A total of 11 breasts were included. Four (36.4%) were NSM and seven (63.6%) were SSM. Nipple to sternal notch distance in NSM and SSM was 32.3±9.1cm and 35.1±4.4cm, respectively. No complications occurred, while one breast with NSM showed nipple upward displacement. The BREAST-Q indicated significant postoperative improvements in breast satisfaction (20.5 ± 11.3 vs 80.2 ± 10.4) and psychosocial well-being (23.4 ± 8.9 vs. 81.4 ± 11.3).
Preliminary study demonstrated the efficacy and long-term safety of "autologous breast dermal filler." For adolescents, it is a less invasive autologous breast reconstruction method, or transitional plan for further adjustment in adulthood.
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对于青春期女性而言，病理性巨乳症导致的乳房切除术通常会带来严重的心理问题。因此，需要一种合适的即时乳房重建方法。
本研究旨在介绍一种无需植入物且不牺牲供区的新型乳房重建方法。
选取所有被诊断为病理性巨乳症且适合保留乳头或保留皮肤的乳房切除术（NSM或SSM）的患者。去除所有多余皮肤的上皮，然后通过乳房下极的垂直切口进行NSM或SSM。接着，在各个方向形成皮肤和真皮包膜。是否保留乳头乳晕复合体取决于其血运情况。将真皮瓣向内折叠作为“自体真皮填充物”来重建乳房。至少6个月后进行第二次手术抬高乳房下皱襞以获得更大的隆起。随访至少1年，并记录并发症以及术前和术后的BREAST-Q评分。
共纳入11个乳房。4个（36.4%）为NSM，7个（63.6%）为SSM。NSM和SSM中乳头至胸骨切迹的距离分别为32.3±9.1cm和35.1±4.4cm。未发生并发症，1例NSM乳房出现乳头向上移位。BREAST-Q评分显示术后乳房满意度（20.5±11.3对80.2±10.4）和心理社会幸福感（23.4±8.9对81.4±11.3）有显著改善。
初步研究证明了“自体乳房真皮填充物”的有效性和长期安全性。对于青少年来说，这是一种侵入性较小的自体乳房重建方法，或成年后进一步调整的过渡方案。
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