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保留乳头乳房切除术后分期乳房上提术重塑乳房的视频指南。

A Video Guide to Reshaping the Breast Through Staged Mastopexy After Nipple-Sparing Mastectomy.

作者信息

Campbell Kelly A, Whalen Kristen, Le Nicole K, Tyle Madison, Doyle William Nicholas, West William, Nehila Timothy, Kuykendall Lauren

出版信息

Aesthet Surg J Open Forum. 2025 May 7;7:ojaf038. doi: 10.1093/asjof/ojaf038. eCollection 2025.

DOI:10.1093/asjof/ojaf038
PMID:40874076
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12378437/
Abstract

Nipple-sparing mastectomy (NSM) has gained popularity because of its improved aesthetics and oncological outcomes. This study focuses on staged mastopexy as a technique for optimizing aesthetics in patients with a history of NSM and implant-based reconstruction. The authors aim to evaluate staged mastopexy as a technique to address complications such as implant and nipple-areolar complex malposition, rippling, and ptotic skin envelope, with a focus on patient selection, surgical technique, and patient-reported outcomes. The authors performed a retrospective analysis on a series of 5 patients who underwent NSM and immediate implant-based reconstruction with staged mastopexy by a single surgeon between 2020 and 2023. Descriptive analyses and -tests were used. Significance was defined as ≤ .05. The cohort consisted of 5 patients (10 breasts) with a median age of 43 ± 6.5 years, and average BMI was 22.9 ± 2.2 kg/m. The mean interval from mastectomy to mastopexy was 431.5 ± 232.1 days. Notably, no cases of partial or total nipple necrosis were observed. BREAST-Q surveys revealed significantly higher satisfaction scores for breasts (74 ± 19.9, = .01) compared with normative values, with an 80% response rate. Staged mastopexy demonstrates a safe and reproducible technique for correcting nipple and implant malposition following NSM and implant-based reconstruction. 4 (Therapeutic).

摘要

保乳乳房切除术(NSM)因其改善的美学效果和肿瘤学结局而越来越受欢迎。本研究聚焦于分期乳房上提术,作为一种优化有NSM病史且采用乳房植入物重建患者美学效果的技术。作者旨在评估分期乳房上提术作为一种解决诸如植入物和乳头乳晕复合体位置异常、波纹和皮肤包膜下垂等并发症的技术,重点关注患者选择、手术技术和患者报告的结局。作者对2020年至2023年间由一名外科医生对5例接受NSM并即刻采用乳房植入物重建及分期乳房上提术的患者进行了回顾性分析。采用描述性分析和检验。显著性定义为P≤0.05。该队列由5例患者(10个乳房)组成,中位年龄为43±6.5岁,平均体重指数为22.9±2.2kg/m²。从乳房切除到乳房上提术的平均间隔时间为431.5±232.1天。值得注意的是,未观察到部分或全部乳头坏死病例。BREAST-Q调查显示,与标准值相比,乳房的满意度得分显著更高(74±19.9,P = 0.01),回复率为80%。分期乳房上提术证明是一种安全且可重复的技术,用于纠正NSM和乳房植入物重建后的乳头和植入物位置异常。4(治疗性)

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a396/12378437/b38e626b7b86/ojaf038f1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a396/12378437/b38e626b7b86/ojaf038f1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a396/12378437/b38e626b7b86/ojaf038f1.jpg

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本文引用的文献

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How to Optimize Prepectoral Breast Reconstruction.如何优化胸肌前置乳房重建。
Aesthet Surg J. 2020 Nov 17;40(Suppl 2):S22-S28. doi: 10.1093/asj/sjaa214.
2
Optimizing Aesthetic Outcomes in Breast Reconstruction After Nipple-Sparing Mastectomy.优化保留乳头乳晕的乳房切除术(NSM)后乳房重建的美学效果。
Aesthet Surg J. 2020 Nov 17;40(Suppl 2):S13-S21. doi: 10.1093/asj/sjaa139.
3
Correction of Suboptimal Results in Implant-Based Breast Reconstruction.假体乳房重建中矫正不理想结果
Aesthet Surg J. 2020 Nov 17;40(Suppl 2):S38-S44. doi: 10.1093/asj/sjaa132.
4
Nipple-Sparing Mastectomy and Prepectoral Implant/Acellular Dermal Matrix Wrap Reconstruction in Large Ptotic Breasts.保留乳头的乳房切除术及胸前植入物/脱细胞真皮基质包裹重建术治疗重度下垂乳房
Plast Reconstr Surg Glob Open. 2019 Jul 25;7(7):e2289. doi: 10.1097/GOX.0000000000002289. eCollection 2019 Jul.
5
A New Approach to Nipple-sparing Mastectomy and Reconstruction in the High Risk Ptotic Patient.高危乳房下垂患者保留乳头乳房切除术及重建的新方法。
Plast Reconstr Surg Glob Open. 2018 May 10;6(5):e1779. doi: 10.1097/GOX.0000000000001779. eCollection 2018 May.
6
A Prospective Comparison of Short-Term Outcomes of Subpectoral and Prepectoral Strattice-Based Immediate Breast Reconstruction.胸大肌下和胸肌前 Strattice 基底即刻乳房重建的短期结果的前瞻性比较。
Plast Reconstr Surg. 2018 May;141(5):1077-1084. doi: 10.1097/PRS.0000000000004270.
7
The Effect of Implant Type on Nipple Position Geometry and Aesthetics Following Tissue Expander Reconstruction After Nipple Sparing Mastectomy.保留乳头乳晕复合体的乳房切除术组织扩张器重建术后,种植体类型对乳头位置几何形状和美学效果的影响。
Aesthet Surg J. 2018 May 15;38(6):605-613. doi: 10.1093/asj/sjx210.
8
Breast Cancer and Reconstruction: Normative Data for Interpreting the BREAST-Q.乳腺癌与乳房重建:解读BREAST-Q的规范数据
Plast Reconstr Surg. 2017 May;139(5):1046e-1055e. doi: 10.1097/PRS.0000000000003241.
9
Patient-Reported Outcomes of Aesthetics and Satisfaction in Immediate Breast Reconstruction After Nipple-Sparing Mastectomy With Implants and Fat Grafting.保留乳头的乳房切除术后即刻乳房重建中使用植入物和脂肪移植的美学和满意度的患者报告结局
Aesthet Surg J. 2017 Oct 1;37(9):999-1008. doi: 10.1093/asj/sjx048.
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Nipple-Areola Complex Malposition in Nipple-Sparing Mastectomy: A Review of Risk Factors and Corrective Techniques from Greater than 1000 Reconstructions.保乳手术中乳头乳晕复合体错位:对1000余例乳房重建病例的危险因素及矫正技术回顾
Plast Reconstr Surg. 2017 Aug;140(2):247e-257e. doi: 10.1097/PRS.0000000000003507.