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。     

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.     

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。     

乳晕切口法解剖型假体隆乳术治疗轻度乳房下垂

目的探讨应用解剖型假体(又称泪滴型假体)隆乳术矫正轻度乳房下垂的可行性及临床效果。方法术前依据原乳房三维形态,测量胸乳距、乳房基底宽度、乳头至乳房下皱襞距离等数据,以确定所需采用的假体类型、容量及下垂乳房下皱襞距离,选用乳晕切口对36例轻度乳房下垂者应用麦格410解剖型假体行隆乳术。结果全部隆乳者术后乳房挺拔,下垂基本得到矫正,受术者均表满意。结论应用解剖型假体的隆乳术是目前矫正有增大乳房容积愿望的轻度乳房下垂者的最佳选择之一。     

内窥镜辅助胸肌筋膜后假体置入矫正乳房下垂

目的:探讨通过内窥镜辅助假体置入在胸肌筋膜下纠正乳房下垂的可行性。方法:本组患者共18例,均为轻度乳房下垂患者,经腋下切口,通过内窥镜辅助将硅凝胶乳房假体放置于胸肌筋膜后。结果:术后随访3~18个月(平均6.5个月),乳房外形良好,下垂基本矫正,未见假体包膜挛缩,无血肿、感染等并发症发生。结论:通过内窥镜技术与胸肌筋膜下隆乳技术相结合,将原本通过乳晕切口才能完成的手术,通过腋窝切口完成,使乳房表面不遗留瘢痕,满足了求美者的需求,同时降低了并发症,提高了手术效果,是矫正乳房下垂的一种较好方法。     

经乳晕切口双平面隆乳术

乳房轻度下垂可通过硅凝胶假体置入乳腺后间隙予以矫正,但对乳房下垂伴皮肤、皮下组织及乳腺组织匮乏或胸大肌发达者,前者假体的被覆组织较薄,可能触及假体;后者则假体与被覆组织(皮肤皮下组织及胸大肌)很难融为一体,无法有效矫正乳房下垂,易形成乳房上部隆起而下部依然下垂的"双泡"畸形.为有效矫正上述畸形,我们曾采用联合切口(腋窝横皱襞切口联合乳房下皱襞小切口)双平面隆乳[1],但因部分患者不愿接受双切口,为此我们改用经乳晕切口双平面隆乳.自2003年以来,我们先后完成10例手术,取得良好的手术效果.     

经乳晕切口双平面隆乳术

乳房轻度下垂可通过硅凝胶假体置入乳腺后间隙予以矫正,但对乳房下垂伴皮肤、皮下组织及乳腺组织匮乏或胸大肌发达者,前者假体的被覆组织较薄,可能触及假体;后者则假体与被覆组织(皮肤皮下组织及胸大肌)很难融为一体,无法有效矫正乳房下垂,易形成乳房上部隆起而下部依然下垂的"双泡"畸形.为有效矫正上述畸形,我们曾采用联合切口(腋窝横皱襞切口联合乳房下皱襞小切口)双平面隆乳[1],但因部分患者不愿接受双切口,为此我们改用经乳晕切口双平面隆乳.自2003年以来,我们先后完成10例手术,取得良好的手术效果.     

经乳晕切口双平面隆乳术

乳房轻度下垂可通过硅凝胶假体置入乳腺后间隙予以矫正,但对乳房下垂伴皮肤、皮下组织及乳腺组织匮乏或胸大肌发达者,前者假体的被覆组织较薄,可能触及假体;后者则假体与被覆组织(皮肤皮下组织及胸大肌)很难融为一体,无法有效矫正乳房下垂,易形成乳房上部隆起而下部依然下垂的"双泡"畸形.为有效矫正上述畸形,我们曾采用联合切口(腋窝横皱襞切口联合乳房下皱襞小切口)双平面隆乳[1],但因部分患者不愿接受双切口,为此我们改用经乳晕切口双平面隆乳.自2003年以来,我们先后完成10例手术,取得良好的手术效果.     

经乳晕切口双平面隆乳术

乳房轻度下垂可通过硅凝胶假体置入乳腺后间隙予以矫正,但对乳房下垂伴皮肤、皮下组织及乳腺组织匮乏或胸大肌发达者,前者假体的被覆组织较薄,可能触及假体;后者则假体与被覆组织(皮肤皮下组织及胸大肌)很难融为一体,无法有效矫正乳房下垂,易形成乳房上部隆起而下部依然下垂的"双泡"畸形.为有效矫正上述畸形,我们曾采用联合切口(腋窝横皱襞切口联合乳房下皱襞小切口)双平面隆乳[1],但因部分患者不愿接受双切口,为此我们改用经乳晕切口双平面隆乳.自2003年以来,我们先后完成10例手术,取得良好的手术效果.     

经乳晕切口双平面隆乳术

乳房轻度下垂可通过硅凝胶假体置入乳腺后间隙予以矫正,但对乳房下垂伴皮肤、皮下组织及乳腺组织匮乏或胸大肌发达者,前者假体的被覆组织较薄,可能触及假体;后者则假体与被覆组织(皮肤皮下组织及胸大肌)很难融为一体,无法有效矫正乳房下垂,易形成乳房上部隆起而下部依然下垂的"双泡"畸形.为有效矫正上述畸形,我们曾采用联合切口(腋窝横皱襞切口联合乳房下皱襞小切口)双平面隆乳[1],但因部分患者不愿接受双切口,为此我们改用经乳晕切口双平面隆乳.自2003年以来,我们先后完成10例手术,取得良好的手术效果.     

Vertical Scar Mastopexy with an Implant

We describe a technique for the correction of ptotic and hypoplastic breasts that combines the vertical scar technique with the insertion of a subpectoral saline implant. This operation consists of a vertical elliptical skin incision through which we make a subpectoral pocket, insert a smooth surface implant, sit the patient up, and mark a new nipple placement. We then remove a wedge of breast tissue above the areola to position it at the marked spot. This simple technique has few complications and a high level of patient satisfaction.     

经乳头根部小切口盐水假体隆乳术-30例临床回顾

目的：选择合适的皮肤切口入路，操作方便，组织损伤小，术后瘢痕不明显是未来隆乳术的发展方向。基于这一原则，笔者选择经乳头根部小切口行盐水假体隆乳术，旨在观察术后的效果。方法：全麻或局麻下，于乳头下侧缘距基底部2mm处设计半环形切口。对于乳头过小者，可向两侧乳晕水平方向延长5mm，总长度小于2．5cm。沿此切口切开皮肤全层，沿乳腺导管走行方向分离，在乳腺下或胸大肌下制造腔穴，将充注式盐水袋假体置入腔穴。再将200ml～300ml盐水通过阀门注入。观察双侧乳房大小、形状、对称性均满意后分层缝合和包扎。结果：从2000年1月～2007年12月，我们用此种方法行隆乳术30例。术后早期5例患者出现乳头感觉暂时减退，1～3月后均恢复正常。10例乳房表面出现局部轻微褶皱塌瘪，2例假体破裂，取出后再次置入新假体。无乳头畸形、包膜挛缩、双侧不对称，所有患者对切口瘢痕感到满意。结论：经乳头根部小切口置入盐水充注式假体手术，操作简便，安全性高，损伤乳腺组织少，愈后切口瘢痕隐蔽。该术式是可行的，值得在临床上推广应用。     

内窥镜下双平面隆乳术对小乳症合并乳房下垂的矫治研究

目的:研究内窥镜下双平面隆乳术矫治小乳症合并乳房下垂的效果及安全性。方法:对42例小乳症合并乳房下垂患者在内窥镜下实施双平面隆乳术,对患者随访6个月～1年观察乳房矫正效果。结果:42例患者乳头上提(1.9±0.3)cm;术后乳房未下垂+Ⅰ度下垂比例高于术前(P<0.01);隆乳术总体优良率为92.85%;除了1例BakerⅢ级以外,其余均未发生并发症。结论:内窥镜下双平面隆乳术对小乳症合并乳房下垂矫治效果好,切口隐蔽,乳房形态自然、饱满。     

Reduction mammoplasty using a modified "B" shape method

This article presents a technique of reduction mammoplasty that is modified from the "B" operation for breast reduction devised by Dr Regnault. The overall excision line resembles the letter "B". The advantages of this technique are as followings: 1. It avoids incision in the so-called hypertrophic areas of the chest. 2. The patient has only a short curved scar (the medial horizontal branch of classic inverted-T incision is eliminated) that is not visible laterally. 3. Because there is no skin undermining, and the nipple is transposed on a upper semicircular dermal flap, so the blood supply of the nipple and areola is very good. 4. Ptotic and hypertrophic breasts can be treated with this method. 5. The resulting shape of the breast was satisfactory.     

Prospective Study Comparing Two Brands of Cohesive Gel Breast Implants with Anatomic Shape: 5-Year Follow-Up Evaluation

BACKGROUND : The new generation of breast implants has an anatomic shape. These implants are made with a textured shell and filled with a cohesive silicone gel. Available since 1993 except in the United States, these implants are gaining in popularity for breast enlargement and reconstruction. This prospective, randomized, controlled, and blinded study was designed to compare mid- and long-term results with the use of cohesive gel-filled implants from two different manufacturers: Style 410 of the McGhan brand (MG) made by Allergan and Vertex made by Eurosilicone (ES). METHODS: From May 1997 to May 1999, 80 women underwent breast augmentation: 40 with Style 410 implants (MG) and 40 with Vertex implants (ES). All surgeries were performed by the same surgeon (I.N.). Another physician (G.J.) interviewed and examined 64 of these women (80%) 4 to 6 years (median, 5 years) after implantation. In addition, 10 patients responded to the same questionnaire and were interviewed by phone, bringing the follow-up rate to 92.5%. RESULTS: Overall, satisfaction was high, with 98.6% of the patients evaluated after 4 to 6 years "very satisfied" or "satisfied" with the result in general. Approximately 20% of the patients who responded judged their breasts to be firmer than desirable. Breast augmentation classification (BAC) was used to grade the breast firmness of the 64 patients examined by G. J. At examination, 24% of patients had soft breasts, 53% had slightly firm breasts, and 23% had moderately firm breasts. That last category also was classified as capsular contracture. No patient was graded as having very hard breasts (BAC 4). Skin sensitivity of the breast adjacent to the incision was altered for 25% of the patients. The implant rotated in four patients (5%). Breast firmness, implant palpability, nipple sensitivity, and skin sensitivity were further analyzed by implant location (submuscular vs subglandular) and implant size (volume). Frequency of the breast asymmetries and the impact of augmentation on asymmetric breasts also was studied. All these analyses were performed with the entire pool of examined patients who answered the follow-up questionnaire. Data also were analyzed by distinguishing between results of the two each implant manufacturers. The results showed no difference between the Eurosilicone and McGhan implants except for the self-evaluation of "breast consistency" by the patient. A higher percentage of patients with the Vertex implants than with the McGhan implants reported that their breast was "firmer than desired." CONCLUSIONS: Breast augmentation with anatomic, textured, cohesive silicone gel-filled implants is a reliable procedure with consistently good results. The results also show that candidates for breast enlargement should be informed that their implanted breast may feel firmer than their natural breasts. They also may experience reduced sensation of their nipple or breast skin.     

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。     

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。     

Endoscopic Transaxillary Capsulectomy

Background Traditionally, breast implant extraction and capsulectomy have been performed using a transareolar approach. However, this approach is not acceptable to Chinese patients because of the additional scar formation. The authors present their experience with capsulectomy using transaxillary endoscopic assistance without the need for an additional incision. Methods The former transaxillary incisional scar for augmentation mammoplasty is used. Blunt dissection is performed to the outer surface of the fibrous capsule. A 30°, 10-mm endoscope is placed through the axillary incision to dissect the outer surface of the capsule. After this is finished, the capsule is cauterized open, and extraction is completed. Transaxillary capsulectomy is performed under endoscopic control. Results From 2003 to 2005, a total of 30 breasts involving 15 patients were treated. The follow-up period was 4 to 6 months, with favorable results. No scar was left on the breast, and no additional scar was made. No liquid accumulation was identified. Conclusions Endoscopic transaxillary capsulectomy can be completed through the axillary incision. The technique successfully removed the fibrous capsule, eliminated the needed for an incision on the breast, and created an incision far from the breast for completion of the procedure.     

扩大背阔肌肌皮瓣乳房再造

目的　介绍单纯应用扩大背阔肌肌皮瓣进行乳房再造方法。方法　将背阔肌周围脂肪组织分为 5个区 ,在背部设计半月形皮肤切口 ,切取背阔肌及周围脂肪组织 ,不应用乳房假体 ,进行即时或后期乳房再造。结果　应用该方法乳房再造 35例 ,再造乳房形态良好。结论　扩大背阔肌肌皮瓣乳房再造 ,安全有效 ,再造乳房形态良好 ,是乳房再造的重要进展。