横行腹直肌肌皮瓣移植乳房再造术的后期修整

目的:探讨横行腹直肌肌皮瓣(TRAM皮瓣)移植乳房再造术的后期修整方法。方法:乳腺癌患者乳房再造术后3~6个月随访时若发现乳房或腹壁形态有所欠缺即可根据具体情况进行各项后期修整。结果:32例TRAM皮瓣移植乳房再造术患者在术后进行了各项后期修整手术,包括局部抽吸术、局部充填术、腹部供区"猫耳朵"修整、腋前襞形态矫正、变性脂肪硬结切除、瘢痕修整及创缘修整、假体置入体积增大、对侧乳房修整手术等。其中6例为1项修整手术,11例为2项修整手术,10例为3项修整手术,5例为4项修整手术。结论:通过后期修整,再造乳房及腹部供区可以进一步地达到外形的完善。

Subsequent Stage Plastic Surgery of Reconstructive Mamaplasty with Transverse Rectus Abdominis Myocutaneous Flap Transplantation

Objective:The aim of this study was to discuss the subsequent stage plastic surgery of reconstructive mamaplasty with transverse rectus abdominis myocutaneous(TRAM)flap transplantation.Methods:The patients were followed up from 3 to 6 months after reconstructive mamaplasty.On the condition that defected configuration of breasts or abdominal wall were noticed,plastic surgeries were performed,respectively.Results:Thirty-two patients of breasts reconstruction with TRAM flap underwent various subsequent stage plastic surgeries,including topical liposuction,topical filling,'dog ear' correction of abdominal donor area,rectification of anterior axillary fold,excision of degenerated fat node,finishing of scar and wound line,augmentation with implants,contralateral breast plastic surgery.Among these patients,6 were given 1 plastic operation,11 were 2 operations,10 underwent 3 operations and 5 underwent 4 operations.Conclusion:After subsequent stage amendment,the appearance of the reconstructive breast and the abdominal donor site would be further improved.