Keane Alexandra M, Tandon Damini, Tenenbaum Marissa M, Myckatyn Terence M
From the Division of Plastic and Reconstructive Surgery, Washington University in St. Louis School of Medicine.
Plast Reconstr Surg. 2025 Feb 1;155(2):433e-446e. doi: 10.1097/PRS.0000000000011764. Epub 2025 Jan 20.
After studying this article, the participant should be able to: (1) Understand the unique differences between mastopexy in aesthetic and reconstructive breast surgery. (2) Describe the approach to performing mastopexy with autoaugmentation or after explantation. (3) Have insight into the approach and decision-making process for performing mastopexy with nipple-sparing mastectomy. (4) Apply the mastopexy skin reduction techniques to ptotic women undergoing postmastectomy breast reconstruction.
Techniques and indications for mastopexy are expanding. In aesthetic surgery, access to supportive meshes and higher rates of breast implant explantation without replacement contribute to this. In breast reconstruction, higher rates of nipple-sparing mastectomy and higher expectations for cosmetically favorable outcomes with ptotic breasts are key drivers. A keen understanding of the available blood supply and how it may change over time with a staged approach, thoughtful use of otherwise-discarded tissues, and judicious application of mesh support are important new considerations for plastic surgeons to apply to traditional mastopexy. This evidence-based article focuses on specific aesthetic and reconstructive mastopexy techniques associated with autoaugmentation, explantation, and nipple-sparing mastectomy.
在学习本文后，参与者应能够：（1）理解美容性乳房手术和重建性乳房手术中乳房上提术的独特差异。（2）描述采用自体增大或取出假体后进行乳房上提术的方法。（3）深入了解保留乳头的乳房切除术联合乳房上提术的方法及决策过程。（4）将乳房上提术的皮肤缩减技术应用于乳房切除术后乳房重建的下垂女性。
乳房上提术的技术和适应证正在不断扩展。在美容手术中，可获得支持性网片以及更高比例的乳房假体取出后不再置换，促成了这一情况。在乳房重建中，更高比例的保留乳头的乳房切除术以及对下垂乳房美容效果的更高期望是关键驱动因素。整形外科医生在传统乳房上提术中应用时，深入理解可用的血供以及分期手术时其随时间可能发生的变化、谨慎使用原本会被丢弃的组织以及明智地应用网片支撑是重要的新考量因素。这篇循证文章聚焦于与自体增大、假体取出和保留乳头的乳房切除术相关的特定美容性和重建性乳房上提术技术。
