乳房缩小整形术的并发症及处理

乳房缩小整形术的并发症及处理乔群乳房缩小整形术是乳房整形术中常见而又复杂的手术之一。常见，是指手术方法繁多。近一世纪以来，世界上的许多著名的整形外科医生都致力于乳房缩小整形术的研究，创造出了近２０种各具特点的术式。复杂，是说尽管乳房缩小整形术有较高的...     

乳房缩小整形术的并发症及处理

乳房缩小整形术是乳房整形术中常见而又复杂的手术之一。常见,是指手术方法繁多。近一世纪以来,世界上的许多著名的整形外科医生都致力于乳房缩小整形术的研究,创造出了近20种各具特点的术式。复杂,是说尽管乳房缩小整形术有较高的成功率,但仍有许多不尽人意的结果出现。现重点叙述乳房缩小整形术的并发症、不满意的手术结果以及出现上述问题的可     

中心蒂法乳房缩小整形术后常见并发症及处理

2003年10月至2010年3月,我们应用中心蒂法乳房缩小整形术治疗158例患者,现将本组病例术后常见的并发症发生原因和处理方法总结如下.1 临床资料本组共158例,均为女性,年龄31～47岁,未哺乳32例,已哺乳126例,切除乳腺组织量150～800 g,平均375 g,平均住院时间10 d.158例中获随访96例,时间为6个月至5年,平均28个月.本组病例术前健康状况均良好,且均无吸烟、饮酒史、糖尿病及家族病史等.     

巨大乳房缩小整形术

本文报告4例巨大乳房采用Mckissock’s改良法缩小整形获得满意效果。 Mckissock’s改良又称三瓣整形法,它保留了Mckissock’s方法定位简便,创伤小,出血不多,双蒂血供不易使乳头乳晕坏死及术后能获得满意的圆锥体乳形的优点,又由于在垂直真皮瓣下附设一可变数的等边三角瓣,避免了再造乳房两翼缝合时皮瓣张力过大而     

中心蒂法乳房缩小整形术后常见并发症的护理体会

目的:探讨中心蒂法乳房缩小整形术术后常见并发症发生的原因及防治措施.方法:对2003年10月至2010年3月行此项手术的158例病人的临床资料进行研究,并对其中得到随访(6个月至5年)的96例远期手术效果进行评价.结果:158例患者的近期并发症中切口愈合不良7例(4.4%),血肿、血清肿6例(3.8%),术后乳晕不圆4例(2.5%),乳晕周围皱着过大3例(1.9%),乳头乳晕复合体塌陷2例(1.3%),乳头乳晕感觉障碍1例(0.6%),未发生皮瓣坏死及脂肪液化等并发症.96例得以随访者乳晕周围瘢痕变宽、乳晕增大8例(8.3%),乳房形态不良4例(4.2%),乳房继发下垂3例(3.1%),其余病例外观和自我感觉均良好.结论:中心蒂法乳房缩小整形术是适合中国妇女的优秀手术方式,其术后并发症的发生与术者的手术经验技巧和对手术细节的重视程度有密切关系.针对性改良优化手术环节,注重围手术期的细节处理,能明显降低术后并发症的发生.     

乳房缩小整形术13例

乳房缩小整形术１３例浙江省嵊县人民医院（３１２４００）唐世懋上海第九人民医院整形外科（２０００１１）张涤生女性乳房除哺乳主要功能外，是女性重要的第二性征之一。健康而丰满的乳房能充分体现出女性美感和魅力。乳房肥大下垂，给患者精神和生理上带来诸多的问题，...     

改良Biesenberger乳房缩小整形术

乳房缩小整形术常用方法很多，效果均较为满意，但困扰着人们的是常留有较为明显的手术瘢痕。为了探求一种瘢痕隐蔽、塑形良好的手术方法，我们对古老的Ｂｉｅｓｅｎｂｅｒｇｅｒ乳房缩小整形术式加以改进：在保留乳房内侧双重血供的情况下，皮下广泛游离，直视下进行乳腺塑形，操作便捷；乳腺组织外上象限切除，切除了肿瘤好发部位，切除量达１／４￣１／３，切除量大；游离乳腺下瓣旋转上移塑形，双“Ｓ”形吻合，塑形灵活，乳腺组     

改良Biesenberger乳房缩小整形术

乳房缩小整形术常用方法很多，效果均较为满意，但困扰着人们的是常留有较为明显的手术瘢痕。为了探求一种瘢痕隐蔽、塑形良好的手术方法，我们对古老的Ｂｉｅｓｅｎｂｅｒｇｅｒ乳房缩小整形术式加以改进：在保留乳房内侧双重血供的情况下，皮下广泛游离，直视下进行乳腺塑形，操作便捷；乳腺组织外上象限切除，切除了肿瘤好发部位，切除量达１／４～１／３，切除量大；游离乳腺下瓣旋转上移塑形，双“Ｓ”形吻合，塑形灵活；乳腺组织悬吊固定在第二、三肋骨骨膜上，固定确切；采用双乳晕切口入路，乳晕周围皮肤裙褶样缝合，经一段时间机体的调节恢复，皱褶逐渐消失，瘢痕不显。随访表明，该法既克服了原法因皮肤潜行分离过广、乳腺游离过大，易发生乳头、乳晕及皮肤坏死的弊端，又展示了切口隐蔽、瘢痕不显的优点。     

Breast lumps after reduction mammaplasty

This paper examines the diagnostic problems raised when breast lumps develop after a reduction mammaplasty. We postulate the etiology and describe how xerograms can help in the diagnosis. We also make a strong case for preoperative xerography.     

双环中央蒂乳房缩小成形术的加网或外侧附加切口技术并发症的特点和适应证

目的 比较双环中央蒂乳房缩小成形术中加网和外侧附加切口的并发症，分析其产生的原因，以避免或减少并发症的发生。方法 回顾2003年8月至2006年5月收治的58例乳房缩小成形术，比较两种方法发生的并发症，包括：感染、血肿、脂肪液化、乳头乳晕血运障碍、皮肤坏死、切口愈合不良、切口瘢痕明显、网片折叠、双侧乳房不对称、缩小程度不足等。结果 加网组19例，发生并发症者6例，其中4例早期并发症患者平均切除腺体重276g；无网也无外侧附加切口3例，无并发症。附加切口组36例，发生并发症者7例（19．4％），其中5例早期并发症患者平均切除腺体重1008g。结论 加网组的并发症主要与网片有关，而附加切口组的并发症与乳房过大、切除腺体多、影响保留的腺体血供有关，改进网片材质和编织工艺、调整网片张力、避免用于表面皮肤过薄的患者，可以减少加网组的并发症。巨大乳房不宜选用双环中央蒂乳房缩小成形术的附加切口法或双环法。     

Quality of life after reduction mammaplasty

Reduction mammaplasty is a common procedure in plastic surgery. Patients seek the operation for neck and lower back pain, and social and emotional problems. The evaluation of health results based on the patient's opinion has become an important and reliable method for the analysis of alterations resulting from treatment. To evaluate the impact of plastic surgery on the quality of life of patients with mammary hypertrophy we used the SF‐36 standardised questionnaire in a prospective study of 44 patients preoperatively and three and six months postoperatively. There were significant improvements in seven of the eight aspects of the SF‐36 (physical function, physical role, pain, energy, social function, emotional role, and mental health). Only general health was unchanged.     

巨乳缩小手术方式比较及相关并发症的处理

目的：探讨巨乳缩小手术的最佳术式及相关并发症的处理。方法：回顾1988年以来作者所在科室实施的56例巨乳缩小手术，总结其成功的经验，并对各种手术方式的优缺点进行了分析和比较，同时对各种并发症的处理提出了作者自己的意见。结果：本组56例受术者，包括8例发生并发症者，经治疗后，疗效均满意。结论：巨乳缩小手术要根据受术者具体的身体条件选择合适的手术方式；其主要并发症包括切口裂开、血肿形成、乳头乳晕坏死等，经对症处理可取得满意效果。     

Quality of life after reduction mammaplasty.

Reduction mammaplasty is a common procedure in plastic surgery. Patients seek the operation for neck and lower back pain, and social and emotional problems. The evaluation of health results based on the patient's opinion has become an important and reliable method for the analysis of alterations resulting from treatment. To evaluate the impact of plastic surgery on the quality of life of patients with mammary hypertrophy we used the SF-36 standardised questionnaire in a prospective study of 44 patients preoperatively and three and six months postoperatively. There were significant improvements in seven of the eight aspects of the SF-36 (physical function, physical role, pain, energy, social function, emotional role, and mental health). Only general health was unchanged.     

乳房缩小整形术后患者生存质量的评价

目前乳房缩小整形术是对女性乳房肥大患者施行的最普通的手术之一，以往报道有关乳房缩小技术的文献较多，而如何通过主、客观指标的改善程度来评价手术效果，是近年来大家关注的话题。为此我们参考了以往文献中所描述的患者要求乳房缩小整形术的始动因素、手术结果对生理和心理变化的影响以及术后并发症等指标，总结出最佳评价手术效果的指标及方法。     

Predicting cup size after reduction mammaplasty.

Presently, predicting cup size after reduction mammaplasty is largely based on experience. Regnault and Daniel (1984) proposed a formula for estimating the appropriate weight of reduction to achieve a desired cup size. To validate their method, we studied 75 consecutive patients undergoing bilateral breast reduction mammaplasty. Patients were measured pre-operatively and 6 weeks post-operatively using two techniques to determine bra size. Actual weight of breast tissue excised was compared to the predicted values using the Regnault and Daniel formula for each measuring technique (Methods A and B). A modified formula (Method C) was developed to increase the accuracy. The results obtained using Methods A and B were compared with those of Method C. A paired sample t test showed no significant difference between actual and predicted weight of reduction for using Method A or C. Method B systematically underestimated the weight of tissue to be removed. The mean estimate for Method B was 730 g, a difference of -45 g (CI: -81.7 to -8.9; p = 0.015). For Method A, the mean was 765.5 g, a difference of 9.4 g (CI: -68.1 to 49.3; p = 0.75). This compared to Method C where the mean predicted weight of tissue to be removed was 770.4 g, a difference of -4.5 g (95% CI: -42.4 to 33.4; p = 0.81). The implications of these findings are discussed.