Shimabukuro Makoto, Ishii Naohiro, Ikura Naohiko, Matsuzaki Kyoichi, Kishi Kazuo
Department of Plastic and Reconstructive Surgery, International University of Health and Welfare Hospital, Tochigi, Japan.
Department of Plastic and Reconstructive Surgery, International University of Health and Welfare, School of Medicine, Chiba, Japan.
Arch Plast Surg. 2025 Mar 24;52(3):119-124. doi: 10.1055/a-2525-5772. eCollection 2025 May.
In breast reconstruction with a flap transfer, symmetry is often difficult to achieve when the contralateral breast projection has a downward peak. Although minimally invasive and effective methods for postoperative correction of the reconstructed breast mound are desirable, none has been comprehensively reported. We devised a correction method comprising downward movement of the reconstructed breast mound using early postoperative dissection and pressure. This method was applied to four patients undergoing primary two-stage ptotic breast reconstruction with a flap transfer. All of their reconstructed breast mounds were positioned above the contralateral side in the early postoperative period. They underwent manual dissection of the upper edge in flaps under local anesthesia 3 weeks after reconstruction or downward pressure correction using a sponge for 6 months or both procedures. The reconstructed breast mound moved 2 to 2.5 cm downward with early postoperative manual dissection or pressure correction using a sponge and moved 3 cm downward with the combination of both dissection and pressure. Manual dissection in the early postoperative period under local anesthesia and compression with a sponge is minimally invasive and useful for the downward correction of the reconstructed breast mound. The combination of dissection and compression provides a greater corrective effect.
在采用皮瓣转移进行乳房重建时，当对侧乳房突度有向下的峰值时，往往难以实现对称。尽管人们期望有微创且有效的方法来对重建的乳房隆起进行术后矫正，但尚未有全面的报道。我们设计了一种矫正方法，包括在术后早期通过解剖和加压使重建的乳房隆起向下移动。该方法应用于4例接受一期两阶段皮瓣转移下垂乳房重建的患者。术后早期，她们所有重建的乳房隆起均位于对侧上方。在重建后3周，她们在局部麻醉下对皮瓣上缘进行手动解剖，或使用海绵进行6个月的向下加压矫正，或同时进行这两种操作。通过术后早期手动解剖或使用海绵进行加压矫正，重建的乳房隆起向下移动2至2.5厘米，而通过解剖和加压相结合则向下移动3厘米。术后早期在局部麻醉下进行手动解剖并使用海绵进行压迫，对重建的乳房隆起向下矫正具有微创性且效果良好。解剖和压迫相结合可提供更大的矫正效果。
