假体置入隆乳包膜挛缩的防治

１０例假体置入隆术后ＢａｋｅｒⅢ－Ⅳ级纤维包膜挛缩者，采用乳晕切口部或分部剥除挛缩包膜后重新置入假体法，术后乳房外形及手感良好。６例随访２年，纤维包膜收缩均限于ＢａｋｅｒⅠ级。对如何防治假体置入隆乳包膜挛缩进行了探讨。     

Experience of injected fat grafting

Eighteen months' experience with the injected fat grafting technique used in 208 patients to correct various problems such as buttocks (augmentation and reshaping), trochanteric depressions, breast augmentation, scar depressions, thighs and legs (calf and ankle augmentation), small wrinkles and depressions of the face (Romberg's disease), nasolabial fold, upper outer breast quadrant, liposuction sequela, fingers and hands is presented. This method shows major advantages with few complications. Some technical details and recommendations for successful fat grafting are also presented.     

Experience and refinements with the supero-medial dermal pedicle for nipple-areola transposition in reduction mammoplasty

The supero-medial dermal pedicle was reported only once in a small group of patients. Further experience and refinements have shown the technique, with a relative thick pedicle augmenting the medial quadrant, to offer good areolar support and permit extensive reduction of the lateral breast.This method was used on 78 patients with a follow-up of up to 2 1/2 years. It was found to be suitable, simple, and safe, and it preserves the sensory qualities of the areola. The increased sophistication and understanding, as presented here, may have borne fruit in the performance of this technique.This work was accomplished in Rotterdam while serving there as a fellow.     

The value of non-prefixed marking in reduction mammoplasty

The advantages of non-prefixed marking for breast reduction are discussed in this paper. The authors use a curved incision modification of the Pitanguy technique, stressing the value of changing the demarcation depending on the skin-gland relationship of each patient.     

经乳晕切口治疗聚丙烯酰胺水凝胶注射隆乳术后并发症

目的：探讨聚丙烯酰胺水凝胶（PAHG）注射隆乳术后并发症及治疗方法。方法：自2003年7月～2009年5月,我科共收治PAHG注射隆乳术后患者67例,年龄32～50岁,均为双侧注射,术前常规行乳腺彩超和MRI检查,明确注射层次和周围组织浸润等情况。术中采用乳晕下缘切口,直视下取出注射物,根据肌肉的完整程度、有无感染以及注射物残留情况决定是否进行Ⅰ期乳房假体置入手术,其中有28例患者Ⅰ期置入乳房假体。结果：本组患者随访6个月～2年,所有患者术前症状基本消失,无假体疝出、感染、切口裂开、双侧乳房不对称等并发症出现,治疗效果良好。结论：经乳晕切口行PAHG取出术可最大程度的取出注射物,可在直视下了解周围组织破坏程度,决定乳房假体置入时机,可取得良好的治疗效果。     

外侧乳腺真皮蒂瓣治疗中-重度巨乳症38例

目的 探讨适合治疗中-重度巨乳症无连接瘢痕新术式.方法采用自行设计外侧乳腺真皮蒂瓣术式治疗中-重度巨乳症38例.结果 术后乳房无乳晕至周边连接瘢痕,随访5年以上乳头乳晕感觉恢复良好,9例患者术后结婚,其中5例生育后哺乳半个月~1年,38例患者中32例对术后乳房形态满意.结论 本术式适合治疗中、度以上巨乳症.     

McGhan解剖型假体在双平面隆乳术中的临床应用研究

目的探讨McGhan解剖型假体在双平面隆乳术中的临床应用研究,并对手术操作经验进行总结。方法全麻下取乳晕切口,McGhan解剖型假体置于腔隙中,其中下1／3部分位于胸大肌后间隙,上2／3部分位于乳腺后间隙。结果术后随访时间6～12个月,本组患者术后外形更为自然,手术效果满意,无包膜挛缩、血肿、瘢痕增生及感染等并发症出现。结论采用了McGhan解剖型假体的双平面隆乳艇合了乳腺后间隙及胸大肌后间隙假体隆乳术的优点,发挥了解剖型假体的优势,临床效果满意。     

Oncoplastic breast surgery and radiotherapy—Adverse aesthetic outcomes,proposed classification of aesthetic components,and causality attribution

The aim of this paper is to discuss and understand the interplay of surgical and radiotherapy (RT) techniques that potentially affect the aesthetic outcomes following breast conservation treatment. It reviews the reported cosmetic outcomes within the practice‐changing RT trials incorporating varied fractionation regimes as well as sequence (before, during, or after surgery) over the past two decades. The paper importantly highlights an overall improvement in breast surgical techniques particularly oncoplastic breast conservation techniques due to dedicated and streamlined training of late. Hence, erstwhile complications or sequel of breast surgery and associated post‐RT aesthetic concerns may not be of the same variety or magnitude that were noted in the past. Paper thus concludes by highlighting the paradigm shift in the breast surgical practice that will have a bearing on the accuracy of RT outcomes assessed (within or out with clinical trials) with implications as a potential research and outcomes assessment gap.