乳房下垂伴小乳房的综合修复术

目的 探讨针对不同程度乳房下垂伴小乳房综合修复治疗的有效手术方法.方法 根据乳房下垂的轻重进行分度,针对不同的分度进行治疗.Ⅰ度下垂伴小乳房,应用胸大肌后间隙置入假体隆胸;Ⅱ度下垂伴小乳房,在Ⅰ度下垂治疗的基础上应用深层乳腺与胸大肌表面脱套剥离及乳腺组织悬吊固定;Ⅲ度下垂伴小乳房,在Ⅱ度下垂治疗的基础上结合双环法多余皮肤切除、深层乳腺与胸大肌表面脱套剥离及乳腺组织悬吊固定;Ⅳ度下垂伴小乳房,应用直线瘢痕法乳房悬吊结合假体隆乳.结果 综合修复治疗乳房下垂伴小乳房116例,无血肿、无感染、无乳头乳晕坏死等并发症发生.术后随访6～31个月,平均随访时间13.3个月,乳房丰满挺拔,乳房下垂得到矫正,乳头乳晕感觉功能正常.结论 针对乳房下垂伴小乳房的不同情况,应用规范化的手术方案可取得较好的临床治疗效果.

Combined strategies in treatment of breast ptosis and breast hypoplasia

Objective To seek an effective surgical procedure to treat patients with the varying degrees of breast ptosis and micromastia.Methods Patients were classified into Ⅰ-Ⅳ degrees based on different breast ptosis,and treated by different methods.Degree Ⅰ was treated with implanting prosthesis to the post-pectoralis major space; degree Ⅱ patients were repaired with avulsion of deeper mammary gland and pectoralis major and hanging fixed breast tissue,based on the degree Ⅰ procedure; degree Ⅲ was fixed with breast tissue flap,excised redundant epidermis by the method of double-rings and the complex of nipple and areola was shifted,based on the degree Ⅱ procedure; degree Ⅳ was repaired with implanting prosthesis and the method of lines to hanging fixed breast.Results In 116 cases of this study,there were no hematoma,infection and nipple and areola necrosis by the combined strategies.The follow-up period after the surgery was 6-31 months （mean 13.3 months）.All cases had voluptuous and upright breasts,rectified breast ptosis,with the normal sense of nipple and areola.Conclusions For breast ptosis and hypoplasia,the combined strategies have better clinical therapeutic effects.