男性乳房发育症的肿胀双环单蒂缩乳术

目的 探讨男性乳房发育症肿胀双环单蒂缩乳整形术式。方法 5年来采用肿胀局麻技术、乳房双环形切口、乳头乳晕外上真皮乳腺单蒂、乳房缩小术治疗男性乳房发育症，共42例80侧乳房。方法 每侧乳房切除100－500g组织，无乳头、乳晕坏死等并发症。随访3－48个月，除乳晕切口处有轻度瘢痕增生、边缘不整齐外，余无异常，效果较为满意。结论 肿胀局麻技术下乳房双环形切口、乳头、乳晕外上真皮乳腺单蒂、乳房缩小术治疗男性乳房发育症，操作简便，安全，损伤轻，出血少，恢复快。     

改良双环单蒂法治疗男性乳房发育症

目的 探讨改良双环单蒂法乳房缩小成形术治疗男性乳房发育症的方法和疗效.方法 设计双环偏心圆切口及乳晕上方真皮蒂,以外环真皮内连续荷包缝合,行乳房缩小成形术.自2008年1月至2010年1月,共收治男性乳房发育症患者11例(20侧乳房).结果 术后随访11例患者3～36个月,均恢复正常男性胸部形态,无复发,无明显乳头、乳晕血液循环障碍等并发症出现.结论 改良双环单蒂法是治疗男性乳房发育症比较理想的方法,值得临床推广.     

双环法及乳头乳晕内上蒂缩乳术治疗重度男子乳腺发育

目的 探讨双环法及乳头乳晕内上蒂缩乳术治疗重度男子乳腺发育症的效果.方法 双环法设计内外环切口,并去除两环间的内上方部分表皮,形成包含真皮、乳腺及皮下组织的乳头及乳晕蒂,切除两环间其余大部分皮肤、腺体及脂肪组织后,将乳头乳晕蒂部适度内旋并与肌膜固定,外环收拢后与内环对位缝合.结果 9例(18侧),除1例单侧乳头乳晕表层坏死外,其余均Ⅰ期愈合,双侧乳房对称、外形满意.结论 利用双环法及乳头乳晕内上蒂缩乳术,可有效治疗重度男子乳腺发育症,内上蒂可确保乳头乳晕血运,并避免后期乳房下垂.     

改良双环法巨乳缩小术

目的：探讨双环法缩乳术的技术改进。用双环形切口，切除外上象限适量乳腺组织对肥大乳房进行缩小和重塑，恢复乳房正常形态。结果：23例46侧术后瘢痕不明显，乳头乳晕无坏死，感觉良好，效果满意。结论：本术式设计简单，满意度高，是治疗巨乳的好方法，有更好的应用前景。     

乳晕新月状切口治疗ⅡB|Ⅲ度男性乳房发育症

目的 探讨乳晕新月状切口治疗ⅡB,Ⅲ度男性乳房发育症的临床效果.方法 4年来采用乳晕新月状切口治疗ⅡB,Ⅲ度男性乳房发育症,共25例41侧乳房.结果 每侧乳房切除120～400 g组织.术后5侧乳头、乳晕表皮坏死.经换药后痊愈.早期部分患者乳头、乳晕区轻度凹陷,以后逐渐恢复.随访4～48个月,切口疤痕不明显,外观满意.结论 乳晕新月状切口治疗ⅡB,Ⅲ度男性乳房发育症,操作简便,创伤小,疤痕隐蔽,美体效果好.     

乳晕切口联合吸脂术治疗青春期男性乳房发育症

目的 探讨乳晕切口联合吸脂术治疗青春期男性乳房发育症的效果.方法 选取2019-02—2020-02郑州大学第一附属医院整形外科收治的18例(33侧乳房)青春期男性乳房发育症患者,年龄16～24岁,病程0.5～12 a,均实施乳晕切口联合吸脂术.术后随访1～3个月,观察并发症及乳房形态.结果 18例患者均未发生皮下血肿...     

乳房外上真皮乳腺单蒂瓣巨乳和垂乳缩小整复术

目的　探讨乳房缩小美容术保持乳头乳晕血运感觉的方法。方法　采用宋氏巨乳缩小术方法设计切口,以乳头乳晕上方及外侧真皮乳腺单蒂供应乳头乳晕血运和神经支配,完成乳腺整形。１９９６ 年１ 月～１９９８ 年１２ 月对１８ 例３０ 侧巨乳和１２ 例２２ 侧垂乳进行手术。结果　新乳房外形满意,乳头乳晕血运感觉保留好。结论　该法切口瘢痕小、乳头乳晕血运感觉良好,适合于不同轻重程度的巨乳垂乳,可作为乳房肥大或松垂的重要手术方法     

上方宽蒂垂直切口乳房缩小成形术

目的 探讨一种减少患者乳头乳晕坏死的上方宽蒂垂直切口乳房缩小成形术.方法 采用Lejour穹窿顶式手术设计,切除乳房下方的皮肤、腺体,乳头乳晕以上方真皮腺体组织宽蒂抬高到正常位置,进行乳房塑形,术后仅留有垂直瘢痕.结果 采用上方宽蒂垂直切口方法行乳房缩小成形术46例,其中4例为单侧乳房缩小,手术效果满意,乳房形态良好.14侧乳房切口部分裂开,其中3侧经清创缝合愈合,其余经换药后愈合,无乳头乳晕坏死发生.结论 上方宽蒂垂直切口乳房缩小成形术效果良好,减少了乳头乳晕坏死的危险,值得推广应用.     

乳晕同心双环切口乳腺区段切除缩乳术

目的：介绍一种乳房缩小术的新方法。方法：以乳头为中心在乳晕缘及其外周作内、外两同心圆切口,两圆半径相距2－4cm,双环间去表皮,在外环切口以外的乳房范围内作广泛的皮下分离;在剥离出的乳腺内、外及下方分别对乳腺组织作放射状桔瓣样楔形区段切除,保留第4肋间神经径路的乳腺组织和剩余乳腺结构的完整性,分层缝合缺损部乳腺组织,利用乳晕外周的真皮帽与其周围的乳腺组织塑形缝合,用7号丝线在乳腺上部向第2、3肋固定缝合数针。外圆环切口用荷包式缝合,将其缩小到与内圆环切口相等,然后缝合切口。结果：共为8例15只乳房轻、中度巨乳症施行手术,乳头、乳晕无坏死且功能良好,切口瘢痕不明显,形态满意。随访病例中1例婚育者哺乳功能良好。结论：乳晕同心双环切口乳腺基底蒂乳腺区段切除缩乳术是一种无明显瘢痕、形态好,保持乳房功能、设计更合理的术式,适应于轻、中度肥大乳房的缩乳术。     

双环形切口乳房缩小整形术

目的:探讨乳房缩小整形术中手术方法及术后效果影响因素。方法:应用改良双环法进行乳房缩小整形术85例,术中切除腺体组织150～1200g,将外上侧腺体组织楔形切除后,将乳头-乳晕-腺体组织瓣置于正常解剖位置,以乳头为中心向内侧适度旋转,并适当固定塑形使乳房的上极保持丰满;并对手术后效果进行初步评价。结果:80例患者接受随访,手术后74例患者双侧乳房形态及乳头乳晕对称,乳房上极较丰满,乳头乳晕感觉良好,患者满意,总满意率为92.5%。结论:改良双环法乳房缩小整形术手术后乳房形态良好,患者满意度高,简易调查表显示患者手术后关心的问题首先是乳房形态及乳头乳晕感觉。     

乳晕小切口切除术治疗男性乳房发育症116例

目的 探讨男性乳房发育症的手术治疗方法。方法 回顾性分析4年来采用局部麻醉肿胀技术，乳晕边缘小切口滑行切除增生的乳腺组织治疗男性乳房发育症116例156侧乳房的临床资科。结果每侧乳房切除增生的乳腺组织约50-150g，术后无乳头乳晕坏死等并发症、切口硕痕亦不明显。随访12—36个月，术区外观良好，疗效满意。结论 在局部麻醉肿胀技术下行乳晕小切口潜行切除增生的乳腺，是一种治疗男性乳房发育症的良好方法，手术操作简单、安全、损伤轻、出血少、恢复快。     

The use of a combined technique in reduction mammaplasty (inferior pyramidal and superior glandular techniques)

The management of mammary hypertrophy is a developing process. The common surgical options for reduction mammaplasty include amputation with free nipple graft as well as the bipedicled, inferior pedicle and vertical pedicle techniques. All techniques are used widely. Disadvantages of these procedures include nipple areola necrosis, insensitivity, hypopigmentation, and poor breast projection. Even with the standard modifications of the original techniques, the resultant breast and nipple may be wide and flat. The purpose of this study was to assess whether combined inferior pyramidal pedicle and superior glandular pedicle reduction mammaplasty can optimize nipple and breast projection. Attention will focus on the viability and sensation of the nipple areola complex. Nine patients with mammary hypertrophy were studied. The change in nipple position ranged from 7 to 13 cm. The amount of tissue removed from each breast ranged from 500 to 1150 g. Nipple/areola sensation was retained in all cases with the exception of one breast. Nipple/areola necrosis or hypopigmentation were not observed. Optimal central breast projection was maintained in all patients, and postoperative evaluation was carried out at 12 and 22 months. The patient satisfaction was very high.     

Gynecomastia Treatment with Subareolar Glandular Pedicle

BACKGROUND: Gynecomastia is enlargement of the male breast. Although treatment is not indicated in most cases, aesthetic reconstructive surgery is commonly performed for psychological reasons. The goals in surgical treatment are to restore the breast contour with minimal scar and to protect areolar anatomy and sensation. This clinical study investigates the results of the subareolar glandular pedicle technique, in which the pedicle is dissected 2 mm wider than the areola with a circumareolar incision and the breast tissue is excised en bloc. The technique differs from the classical circumareolar approach with its thinner pedicle and excision of the breast without leaving prepectoral tissue. METHODS: We operated on nine patients with grades 1 and 2 gynecomastia using the subareolar glandular pedicle. Exposure was excellent with the circumareolar incision. Neither hematoma nor seroma formation was seen in any of the patients. Partial areola necrosis, which caused suture separation, was the only early postoperative complication seen, and this in a patient who smoked heavily. Patients were followed for at least 6 months. RESULTS: Eight patients achieved a good aesthetic contour of the chest, and one patient needed a contour revision for the residual mass because of a bulky pedicle. Circumareolar scars were satisfactory for all the patients, including the patient with partial areola necrosis. Circumareolar hyperpigmentation developed in one patient, and areola sensation was preserved in seven patients. CONCLUSIONS: The subareolar glandular pedicle is indicated for grades 1 and 2 gynecomastia. Circumareolar incision provides perfect exposure. The technique is reliable if the pedicle is dissected 2 mm wider than the areola and dissection under the pedicle is avoided. Postoperative circumareolar scarring is minimal and nipple-areola sensation is preserved in most cases. However, experience is needed to determine the pedicle girth because a wide pedicle leads to subareolar bulk, whereas a thin pedicle may cause partial areola necrosis.     

Gynecomastia Treatment with Subareolar Glandular Pedicle

Background Gynecomastia is enlargement of the male breast. Although treatment is not indicated in most cases, aesthetic reconstructive surgery is commonly performed for psychological reasons. The goals in surgical treatment are to restore the breast contour with minimal scar and to protect areolar anatomy and sensation. This clinical study investigates the results of the subareolar glandular pedicle technique, in which the pedicle is dissected 2 mm wider than the areola with a circumareolar incision and the breast tissue is excised en bloc. The technique differs from the classical circumareolar approach with its thinner pedicle and excision of the breast without leaving prepectoral tissue.Methods We operated on nine patients with grades 1 and 2 gynecomastia using the subareolar glandular pedicle. Exposure was excellent with the circumareolar incision. Neither hematoma nor seroma formation was seen in any of the patients. Partial areola necrosis, which caused suture separation, was the only early postoperative complication seen, and this in a patient who smoked heavily. Patients were followed for at least 6 months.Results Eight patients achieved a good aesthetic contour of the chest, and one patient needed a contour revision for the residual mass because of a bulky pedicle. Circumareolar scars were satisfactory for all the patients, including the patient with partial areola necrosis. Circumareolar hyperpigmentation developed in one patient, and areola sensation was preserved in seven patients.Conclusions The subareolar glandular pedicle is indicated for grades 1 and 2 gynecomastia. Circumareolar incision provides perfect exposure. The technique is reliable if the pedicle is dissected 2 mm wider than the areola and dissection under the pedicle is avoided. Postoperative circumareolar scarring is minimal and nipple–areola sensation is preserved in most cases. However, experience is needed to determine the pedicle girth because a wide pedicle leads to subareolar bulk, whereas a thin pedicle may cause partial areola necrosis.     

内镜乳晕小切口男性乳房肥大矫正术

目的探索减少男性乳房肥大整形术后瘢痕,使乳房切除更加精确,更有利于塑形,避免出血、血肿及支配乳头、乳晕感觉神经的损伤。方法对16例患者在内镜监视下,采用乳晕旁2~3.5cm切口,切除肥大的男性乳腺腺体组织,对于以脂肪增生为主者,先行肿胀吸脂术,后在内镜监视下进行残余肥大腺体切除。切除乳腺体组织量单侧为100~320g,平均为130g;吸脂量为20~130ml,平均为68ml,无血肿,切除组织病理检查为脂肪组织及腺体组织。结果术后无血肿,无皮肤坏死,乳头及皮肤的感觉良好,均获随访观察,时间为手术后5个月至3年,无复发。结论内镜外科技术能缩小乳晕切口,避免损伤乳头、乳晕,利于离乳晕较远范围的乳腺组织切除及乳房重新塑形,为男性乳房肥大矫正的一种良好选择。     

环乳晕切口下蒂瓣法矫治巨大乳房

目的:探讨环乳晕切口下蒂瓣矫正特别巨大乳房的临床效果。方法:采取环乳晕切口,以部分去表皮的下蒂瓣为基础,切除乳头乳晕上方、外侧大部分腺体皮肤及内侧部分腺体皮肤组织,上提下蒂瓣,固定重塑乳房腺体形态,再将下蒂两侧的皮肤均匀拉拢,覆盖下蒂瓣,切除多余皮肤,使之形成不超过乳房下皱襞的斜形短切口,乳晕及周围的皮肤真皮层辐射状环缩缝合,缝合皮肤。结果:10例20只乳房,单侧乳房组织平均切除量为1 050g,最大2 200g。随访6~12个月,无乳头坏死、感觉良好,外形饱满。患者对乳房形态、对称性、乳晕大小形状、乳头乳晕感觉及切口瘢痕的满意率分别为100%。结论:环乳晕切口下蒂瓣的巨大乳房缩小整形术,组织切除量大,瘢痕短,并发症少,是一种较好的巨大乳房缩小术式。     

乳晕内下缘弧形切口皮内缝合治疗男性乳房肥大症

目的:探讨通过乳晕内下缘弧形切口切除增生乳腺组织,并采用皮内缝合治疗男性乳房肥大症的手术方法和临床效果。方法:回顾性分析5年来采用局部浸润麻醉或基础麻醉+局部浸润麻醉,在乳晕内下缘取弧形切口切除肥大增生乳腺组织,保留乳头下方的部分乳腺组织垫,治疗59例,76侧男性乳房肥大症的临床资料。结果:59例,76侧男性乳房肥大症患者,经治疗后手术效果确切,血运障碍发生少,术后患者胸部平坦,无凹陷,乳头无异常感觉,外形满意,切口隐蔽,切口痕迹不明显。结论:采用乳晕内下缘弧形切口皮内缝合治疗男性乳房肥大症能有效去除多余的腺体和脂肪组织,创伤小,恢复快,减少了术后乳头乳晕血运障碍的发生,无感觉障碍,而且切口隐蔽,瘢痕细小,是治疗男性乳房肥大症的良好手术方法。     

两种乳晕切口在隆乳术中的应用探讨

目的：比较两种经乳晕不同切口行乳房假体隆乳术的效果。方法：2007年1月～2008年1月期间,28例女性就医者接受经乳晕路径假体隆乳术。随机分为两组,其中A组11例采用乳晕缘下半环切口入路,B组17例采用绕乳头基底部纵行乳晕切口入路。并对两种手术方法及术后6～12个月的随访进行了总结。结果：绕乳头基底部乳晕切口易于假体置入,手术操作灵活方便,保留乳房外形效果更好,术后乳晕部的剥离范围内感觉障碍较轻微,乳头感觉良好,切口瘢痕更加隐蔽。所有就医者于术后接受随访均感满意。结论：和常规经乳晕缘切口相比,绕乳头基底部纵行乳晕切口入路有较多的优点,在美学方面有明显优势,此方法值得在临床上推广应用。     

竖直切口内上蒂巨乳缩小术的临床应用

目的 根据巨乳缩小术的手术原则,探讨一种既能保证乳房血供和功能,又能保持良好乳房外观的手术方式,并观察其临床疗效.方法 本组共10例乳房肥大症患者,采用竖直切口结合内上蒂法行乳房缩小术.根据术前设计,去除内上蒂表皮,形成腺体蒂,再切除外下象限多余的皮肤及腺体,重塑乳房形态.结果 术后无皮肤坏死、脂肪液化、乳头乳晕感觉减退、血肿和感染等并发症发生,切口均Ⅰ期愈合.术后随访3～12个月,患者对术后乳房外观形态及功能均表示满意,能接受术后瘢痕.结论 竖直切口内上蒂巨乳缩小术操作简单、安全,对轻、中度,特别是中度乳房肥大患者特别适用,术后和远期均能达到满意疗效.