Hammad Mai Raafat Abdelazim, Badawy Mohamed Samir, Naguib Eman Nagy, Mabrouk Amr
Department of Plastic, Burn and Maxillofacial Surgery, Ain Shams University, 54 Abdullah Ebn Taher street, Nasr City, Cairo, 11731, Egypt.
Aesthetic Plast Surg. 2025 Feb;49(3):749-757. doi: 10.1007/s00266-024-04344-z. Epub 2024 Sep 19.
Breast deformity following massive weight loss poses a unique challenge inadequately managed by traditional methods. Patients also have considerable lateral and posterior upper trunk tissue surplus. Multiple studies have used chest wall flaps for auto-augmentation with mastopexy to tackle this problem. However, the outcome measures did not include any objective tools to assess the reliability of these flaps. Hence, in this study sono-mammography and breast anthropometric measurements are used for evaluation of the added volume and long-term sustainability of chest wall perforator flaps.
Twenty massive weight loss patients with Pittsburgh Rating Scale score 2-3 underwent mastopexy with autologous augmentation through perforator flaps encompassing lateral chest wall skin. Outcome measures were breast volume, and the presence of fat necrosis on mammography, and direct breast anthropometry.
All patients showed a consistent increase in volume postoperatively and no fat necrosis in postoperative mammography, reflecting flap reliability over one year of follow-up. All postoperative anthropometric measurements showed improvement in the breast deformities addressed.
This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
大量体重减轻后的乳房畸形带来了独特的挑战,传统方法对此处理不当。患者的上躯干外侧和后侧也有大量多余组织。多项研究使用胸壁皮瓣进行自体隆乳并乳房固定术来解决这个问题。然而,结果测量并未包括任何客观工具来评估这些皮瓣的可靠性。因此,在本研究中,使用超声乳腺造影和乳房人体测量学来评估胸壁穿支皮瓣的增加体积和长期可持续性。
20例匹兹堡评分量表评分为2 - 3分的大量体重减轻患者接受了乳房固定术,并通过包含胸壁外侧皮肤的穿支皮瓣进行自体隆乳。结果测量包括乳房体积、乳腺造影上脂肪坏死的情况以及直接乳房人体测量。
所有患者术后体积均持续增加,术后乳腺造影未见脂肪坏死,反映了皮瓣在一年随访期内的可靠性。所有术后人体测量结果均显示所处理的乳房畸形有所改善。
证据等级IV:本刊要求作者为每篇文章指定证据等级。有关这些循证医学评级的完整描述,请参阅目录或在线作者指南 www.springer.com/00266 。