改良双环法乳房下垂矫正术

目的:介绍改良双环法行乳房悬吊术的方法和经验。方法:采用传统的双环法环乳晕切口,切除双环间表皮,在皮肤与上半乳腺的腺体表面之间剥离,去除上半腺体后松弛的浅筋膜深层,上提腺体至正常位置并固定于深筋膜,同时进行腺体的适当折叠塑形或置入乳房假体增加丰满程度。结果:共行轻、中度下垂28例(4例为单侧下垂),其中悬吊加假体隆乳9例;腺体瓣交叉缝合悬吊塑形19例。术后乳房外形改善满意,乳头、乳晕感觉良好,效果持久。结论:本手术方法安全易行,组织损伤小,瘢痕不明显,是矫治轻、中度乳房下垂的一种比较理想的方法。     

多重悬吊双环法矫正乳房下垂的临床应用

目的 探讨多重悬吊双环法矫正乳房下垂及轻中度乳房肥大的方法及临床效果.方法 采用传统的双环法手术切口,在内、外环切口之间去除表皮,形成真皮帽,并在外环切口周围皮下组织与乳腺腺体表面进行广泛分离直至乳房基底部,然后将乳腺组织在中部环形折叠塑形,再行真皮帽悬吊和乳腺上极边缘多点缝合悬吊,荷包缝合内外环皮肤,术后乳房塑形包扎.结果 16例(32侧)患者均Ⅰ期愈合,无乳头、乳晕坏死.随访6～12个月,乳晕周围皮肤皱褶基本消失,瘢痕细小,乳头、乳晕感觉良好,乳房外形美观.结论 多重悬吊双环法矫正乳房下垂可避免对乳房局部过度分离和牵拉,乳房外形美观,悬吊确切、持久,是矫正乳房下垂伴轻、中度乳房肥大的一种比较理想的方法.     

双环复合组织筋膜瓣法矫正乳房下垂的临床应用

目的 探讨应用双环复合组织筋膜瓣法行乳房悬吊术矫治乳房轻、中度下垂的方法及临床效果.方法 在传统的双环形切口乳房缩小整形术的基础上,在皮肤与乳腺的腺体表面间行广泛剥离后,应用蒂在乳腺上半象限的筋膜瓣垂直下拉,缝合固定于下半象限的乳腺与胸大肌之间,并将乳晕内外环的真皮行荷包缝合,术后将乳房塑形包扎.结果 应用双环复合组织筋膜瓣行乳房悬吊术的方法矫治乳房下垂20例,患者均Ⅰ期愈合,无乳头、乳晕坏死.所有患者术后随访6~12个月,乳晕周围皮肤皱褶基本消失,乳房外形美观持久,乳头、乳晕感觉良好,效果满意.结论 改良手术方法技术简便易行,组织损伤小,瘢痕不明显,是矫治轻、中度乳房下垂的一种比较理想的方法,值得推广应用.     

腺体外侧蒂皮肤双环切口乳房塑形悬吊术

目的探讨腺体外侧蒂皮肤双环切口乳房塑形悬吊术,在矫正乳房下垂中的应用.方法自2003年以来,应用外侧蒂双环切口乳房塑形悬吊术,矫正乳房下垂患者30例,"楔"型切除乳房下极部分腺体组织,腺体瓣相对旋转缝合固定于胸肌筋膜,保留部分腺体于内上方皮瓣,乳房上极悬吊至第2、3肋软骨膜.结果术后随访患者1～3个月,均获得满意效果.结论外侧蒂双环切口乳房塑形悬吊术,可以有效地塑形悬吊乳房,术后切口隐蔽,乳房上极饱满,是矫正乳房下垂的一种理想选择.     

改良双环法乳房悬吊术

目的 介绍改良双环法行乳房悬吊术的方法和经验。方法 采用传统的双环法乳房悬吊术切口，在皮肤与乳腺的腺体表面之间行广泛剥离后。在乳腺的下半象限正中将腺体垂直切开，将形成的两部分乳腺复合组织瓣向内上及外上方向旋转后互相交叉重叠缝合固定成形。并将乳晕内外环的真皮行荷包缝合。术后将乳房塑形包扎。结果 采用本方法矫治轻、中度乳房下垂者共8例16侧。术后乳房外形美观持久，乳头、乳晕感觉良好，效果满意。结论 本手术方法简便易行．组织损伤小．瘢痕不明显．是矫治轻、中度乳房下垂的一种比较理想的方法。     

腺体外侧蒂皮肤双环切口乳房塑形悬吊术

目的探讨腺体外侧蒂皮肤双环切口乳房塑形悬吊术,在矫正乳房下垂中的应用。方法自2003年以来,应用外侧蒂双环切口乳房塑形悬吊术,矫正乳房下垂患者30例,“楔”型切除乳房下极部分腺体组织,腺体瓣相对旋转缝合固定于胸肌筋膜,保留部分腺体于内上方皮瓣,乳房上极悬吊至第2、3肋软骨膜。结果术后随访患者1~3个月,均获得满意效果。结论外侧蒂双环切口乳房塑形悬吊术,可以有效地塑形悬吊乳房,术后切口隐蔽,乳房上极饱满,是矫正乳房下垂的一种理想选择。     

改良双环法乳房悬吊术

目的介绍改良双环法行乳房悬吊术的方法和经验.方法采用传统的双环法乳房悬吊术切口,在皮肤与乳腺的腺体表面之间行广泛剥离后,在乳腺的下半象限正中将腺体垂直切开,将形成的两部分乳腺复合组织瓣向内上及外上方向旋转后互相交叉重叠缝合固定成形,并将乳晕内外环的真皮行荷包缝合.术后将乳房塑形包扎.结果采用本方法矫治轻、中度乳房下垂者共8例16侧,术后乳房外形美观持久,乳头、乳晕感觉良好,效果满意.结论本手术方法简便易行,组织损伤小,瘢痕不明显,是矫治轻、中度乳房下垂的一种比较理想的方法.     

经乳晕上切口矫正轻度下垂乳房的隆乳术

目的 一次性完成隆乳并矫正乳房轻度下垂。方法 经乳晕上切口切除半月形皮肤，不切开乳腺置入乳房假体，将乳腺组织上移悬吊固定于胸大肌深筋膜。结果 23例乳房轻度下垂的小乳症患者术后乳房及乳头形态位置良好，乳晕切口瘢痕不明显，乳头感觉及勃起正常，结论 该方法隆乳同时矫正下垂乳房效果可靠稳定，创伤小，止血彻底，瘢痕不明显。     

生物膜片在乳房悬吊术中的应用

目的 探讨用生物膜片行乳房悬吊术治疗乳房下垂的适应证、手术技巧及优点.方法 首先设计悬吊后的乳头位置,然后对乳房轻度下垂者于乳晕上缘行"橘瓣"样切口,对中、重度下垂者采用"双环"样切口.沿设计切开皮肤后锐、钝性分离皮肤和乳腺组织,锐性分离皮下脂肪与腺体后将生物膜片置入.自2007年12月至2009年10月,对18例乳房下垂患者行乳房悬吊.结果 术后随访其中的14例患者3～18个月,下垂乳房上提高度2～6 cm,有效率达100%;乳房上极饱满、外形佳.其中有2例乳房中度下垂患者的右侧乳晕上缘切口处瘢痕较明显,余者均正常.患者满意率约为93%.结论 将生物膜片应用于乳房悬吊术,具有创伤小、操作简单、乳房外形佳、效果确实持久且安全等优点,值得在临床上推广使用.     

经乳晕上切口矫正轻度下垂乳房的隆乳术

目的　一次性完成隆乳并矫正乳房轻度下垂。方法　经乳晕上切口切除半月形皮肤 ,不切开乳腺置入乳房假体 ,将乳腺组织上移悬吊固定于胸大肌深筋膜。结果　 2 3例乳房轻度下垂的小乳症患者术后乳房及乳头形态位置良好 ,乳晕切口瘢痕不明显 ,乳头感觉及勃起正常。结论　该方法隆乳同时矫正下垂乳房效果可靠稳定 ,创伤小 ,止血彻底 ,瘢痕不明显。     

双平面隆乳术在矫治小乳症并乳房下垂中的应用

目的：讨论双平面隆乳术在矫治小乳症并乳房下垂中的临床应用。方法：选择22例患者,4例哺乳后乳房萎缩并松垂行单纯双平面隆乳术,18例小乳症并乳房Ⅰ度至Ⅲ度下垂行双平面硅胶假体隆乳及乳房下垂矫正。结果：22例术后随访1个月至1年2个月,平均6．5个月。20例（40只）乳房形态良好,无假体移位、包膜挛缩及畸形。1例（2只）Ⅲ度乳房下垂者因悬吊不够,9个月随访时仍呈现Ⅰ度下垂。1例（1只）乳房硬化,为BakerⅢ。讨论“双平面”法隆乳术,即假体同时位于两个平面（部分位于乳腺下,部分位于胸大肌下）,此方法适用于各类乳房,能避免“双乳房”畸形,术后乳房下部形态美观。     

应用聚丙烯单丝网片纠正轻、中度乳房下垂

目的：介绍一种适用于轻、中度乳房下垂的矫正术。方法：采用乳晕周围环状切口，用聚丙烯单丝网片制成内置式乳罩，行乳腺组织的上提、塑形和固定，并为21例乳房下垂者行矫正术。结果：21例均达到较为理想的上提效果，随访2－16个月，无下垂复发和切口瘢痕增生，未发生异物排斥反应。结论：聚丙烯单丝网片用作乳房塑形的支持材料安全可靠，减少了切口的瘢痕增生，避免了下垂复发。     

Simultaneous breast augmentation and mastopexy

The results of combining breast augmentation and mastopexy are less predictable than those associated with mastopexy or augmentation mammoplasty alone. A method of breast skin envelope reduction is presented that allows the surgeon performing mastopexy to preview the final breast shape before committing to skin resection. This method, first described in 1978, has proven to be technically versatile and reproducible, and applicable not only to moderate (second degree) and severe (third degree) ptosis but also to simultaneous breast augmentation and mastopexy. For the combined procedures, the practical strategy proposed is first the implant placement through a periareolar incision, and a vertical transglandular incision, usually submusculofascial; second, restoring the gland anatomy by closing the muscularis and the vertical transglandular incision; third, skin envelope adjustment using the Tailor-Tack maneuver to accurately assure the best position of the nipple-areolar complex on the breast mound; fourth, skin incision, de-epithelialization and undermining; and finally, closure combining the the Purse-String maneuver with the vertical incision.     

应用解剖型假体隆乳治疗轻中度乳房下垂

目的探讨应用解剖型假体隆乳术治疗小乳症伴轻中度乳房下垂的方法及效果。方法对15例患小乳症伴乳房轻中度下垂者应用解剖型ST-410假体行乳腺下隆乳术，根据术后患者满意度判断手术治疗效果。结果15例乳房轻中度下垂者通过此方法均获得很大改善，患者均感满意。结论应用解剖型假体行乳腺下隆乳术可明显改善轻中度乳腺下垂。     

Augmentation Mastopexy with Implant and Autologous Tissue for Correction of Moderate/Severe Ptosis

Purpose: Breast augmentation combined with mastopexy is associated with a significantly higher complication rate than augmentation alone. The combination of mastopexy and breast implants has revealed a moderate recurrence of breast ptosis in many patients particularly with use of medium to large implants. Ptosis is the “bottoming out” of the breast tissue with loss of the desired roundness, due to the ptosis of the breast implant and the mammary tissue. In this study, we hypothesize the need for careful planning and careful preoperative surgical execution to minimize this complication. Patients and Methods: Between January 2007 and July 2011, augmentation mastopexy with implant and autologous tissue (“double implant”) was performed for 25 patients with grade III mammary ptosis. All patients underwent inverted-T mastopexy with supramuscular moderately cohesive gel breast implant using an inferior-based flap of de-epitelialized dermoglandular tissue and a superior-based nipple-areola complex pedicle. Results: An inferior-based flap of deepithelialized dermoglandular tissue was used to stabilize the implant and is projection. Breast lifting was performed through a strong anchorage to fascia and to muscle of second intercostal space, improving the profile of the breast. Results were analyzed, no breast ptosis recurrence was noted at 30-month follow-up. Conclusions: Our technique presents the challenge of determining the amount of excess skin to be removed after implantation to create symmetry and provide for skin tightening without compromising tissue vascularization.     

Mastopexy with 3D Preshaped Mesh for Long-Term Results: Development of the Internal Bra System

BACKGROUND: Numerous techniques for mastopexy and breast reduction have been described, indicating the absence of a generally accepted method that fulfills the essential criteria for obtaining a pleasing, long-lasting result. All techniques using local tissue for reinforcement will eventually face recurrent ptosis because essentially the physical tissue properties are not altered. To overcome this, synthetic mesh has successfully been used to obtain permanent results. This method, however, was not generally accepted because of the fear of complications and of reduced oncologic survey and because no practical system was in place. Meanwhile, research showed that mesh could be safely introduced into the female breast. METHODS: An easy-to-use mesh implant was developed. It comes as a system consisting of three-dimensional, preshaped, feather-soft woven mesh in different sizes, and concomitant sizers to facilitate the insertion. It acts as an internal bra and is therefore named "the Internal Bra System." The mesh replaces the attenuated natural suspensory system of the breast, returning what was lost by nature. Indications are breast ptosis, breast hypertrophy with ptosis, and contralateral correction after reconstruction. RESULTS: A total of 170 patients (327 breasts) were treated with the longest follow-up of 4.5 years. No serious complications were encountered. Physical and X-ray examinations were still possible. No recurrent ptosis was observed and no scar hypertrophy. CONCLUSION: The Internal Bra System seems to have finally become the versatile way to obtain a predictable, pleasing, long-term result in mastopexy and breast reduction.     

兼顾矫正乳房中度下垂的隆乳术

目的：探讨应用乳晕周围双环切口隆乳同时悬吊乳房,矫正小乳症伴中度乳房下垂的方法。方法：采用乳晕周围双环形切口,在乳腺的上半象限纵行切开,按胸大肌纤维走向钝性分离至胸大肌后形成间隙,置入乳房假体。用4号丝线将切开的乳腺组织与胸大肌分离口两侧贯穿预缝置4针,打结闭合胸大肌分离口的同时将乳腺固定于胸大肌上,上部乳腺组织筋膜同时缝合固定在肋软骨膜上,以达到隆乳术同时矫正乳房下垂。结果：用本法矫正小乳症伴中度乳房下垂者26例,效果良好。结论：本手术方法简单易行,无须附加乳晕周围以外切口,瘢痕不明显,是矫正小乳症伴中度下垂的一种较好方法。     

The correction of breast ptosis with the expander mammary prosthesis

The major disadvantage of breast ptosis correction using the standard mastopexy procedure is the visible scarring. The use of an implant alone is often inadequate, especially in the more ptotic breast. A technique employing a submuscular expandable mammary prosthesis together with release of the breast tissue from the underlying muscle is described. This method enables correction of greater degrees of ptosis than is possible with implant placement alone.