Aesthetic Plast Surg:通过抽脂术重建乳房下皱褶:重建乳房美学必要技术

2022-08-18 医路坦克 MedSci原创

乳房下皱褶(IMF)是乳房重要的美学组成部分,它限制了乳房的下缘,并决定了乳房下垂的程度,本文描述了患者在不同的乳房手术(主要是乳房切除后重建)中重建和确定IMF的技术,并介绍了所取得的长期结果。

乳房下皱褶(IMF)是乳房重要的美学组成部分,它限制了乳房的下缘,并决定了乳房下垂的程度。它的存在和特征对于各种乳房手术后获得满意、自然的结果是极其重要的。乳房切除后,由于广泛的皮下解剖切除了乳腺的大部分尾部边缘,可能会失去乳房下皱褶,但即使在保守的乳房切除术中,如保留乳头皮肤的乳房切除术,乳房下皱褶有时也会被破坏。

在这项回顾研究中,我们描述了患者在不同的乳房手术(主要是乳房切除后重建)中重建和确定IMF的技术,并介绍了所取得的长期结果。

我们报告了2016年1月-2020年6月间所有接受IMF吸脂术的患者。皮下吸脂术是用一个3 mm的钝管沿新的IMF进行,以促进皮肤回缩和皮肤与筋膜之间的粘连。结果由患者进行主观评估,并由8名未参与治疗的个人进行客观评估。

我们对69例患者的88个乳房进行了IMF吸脂术,年龄21~74岁(平均52岁),其中82个乳房植入,2个乳房结节,4个对侧乳房隆胸。平均随访28个月(6~64个月)。

结果:VAS量表评定总体结果达到86.6/100。所有接受采访的22名患者都判断清楚地观察到了新的乳房下皱褶。83%病例的乳房下皱褶被定义为良好或优良,而与对侧IMF的对称性、自然外观和整体美学效果良好。

手术前的标记。IMF在乳房切除侧的位置和曲率与对侧乳房对称。在这种情况下,计划在右侧乳房更换扩张器和植入物,而左侧乳房的隆起则用于改善对称性。因此,与自然的IMF相比,新IMF在左侧的标记处于更接近尾部的位置。以此为参照,新计划中的右侧IMF也被标记为比现有的更接近尾部。

通过在计划的新IMF的中点处的水平3 mm皮肤切口引入长度为15 cm的钝的3 mm套管。IMF外侧半部吸脂术。b . IMF内侧半部吸脂术。另一个在保留乳头皮肤的乳房切除术后直接植入重建的吸脂例子。注意套管的皮下位置

同一患者在术后两个星期仍然使用丝绸带敷料

这些列显示了使用IMF真皮吸脂技术的不同乳房手术(蓝色列显示单独吸脂,粉色列显示缝线定位)。勒根达。EXP/IMPL:扩张器与植入物的交换。IMPL/ IMPL:用新植入物替换破裂的植入物(用于重建)。DTI:直接植入重建。BA:隆胸(胸廓下双平面),用于乳房切除术后重建(4个乳房)或结节性乳房畸形(2个乳房)中对侧乳房的治疗

一个从已经可以接受的术前情况出发微调IMF定义的例子。一名患者在更换扩张器和植入物以及对侧乳晕周围乳房固定术隆乳期间接受了右侧再造乳房的IMF吸脂术,其术前标记(a)和术后结果(b、c、d、e、f)

患者接受了双侧皮下乳房切除术和直接植入重建,乳房尺寸增加。术前正视图(a)。新IMFs (b)计划位置的标记。术后结果(c、d、e)。乳房切除术和植入物定位后,对新的、更靠近尾部的IMF进行吸脂。术后IMF看起来自然且轮廓分明

 

结论:根据我们的实验结果,我们推荐皮下抽脂技术,以提高乳房切除及其他乳房手术后乳房重建中IMF的使用率。它是有效的,易于操作,微创。

 

文献来源:

Pinto V,  Pignatti M,  Contu L, Defining the Inframammary Fold by Liposuction: An Essential Tool in Aesthetic Shaping of the Reconstructed Breast. Technique and Long-term Results in a Series of Patients.Aesthetic Plast Surg 2022 Feb;46(1)

版权声明:
本网站所有内容来源注明为“梅斯医学”或“MedSci原创”的文字、图片和音视频资料,版权均属于梅斯医学所有。非经授权,任何媒体、网站或个人不得转载,授权转载时须注明来源为“梅斯医学”。其它来源的文章系转载文章,或“梅斯号”自媒体发布的文章,仅系出于传递更多信息之目的,本站仅负责审核内容合规,其内容不代表本站立场,本站不负责内容的准确性和版权。如果存在侵权、或不希望被转载的媒体或个人可与我们联系,我们将立即进行删除处理。
在此留言
评论区 (5)
#插入话题
  1. [GetPortalCommentsPageByObjectIdResponse(id=2051835, encodeId=69a4205183559, content=<a href='/topic/show?id=95f8e042dd' target=_blank style='color:#2F92EE;'>#EST#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7042, encryptionId=95f8e042dd, topicName=EST)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e9a6357, createdName=xiangyuzhou971, createdTime=Sun Dec 18 12:05:03 CST 2022, time=2022-12-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1776238, encodeId=501d1e76238b3, content=<a href='/topic/show?id=95d3e9930fe' target=_blank style='color:#2F92EE;'>#美学#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=49, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79930, encryptionId=95d3e9930fe, topicName=美学)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a9de34, createdName=zhangpaul93, createdTime=Mon Jan 16 07:05:03 CST 2023, time=2023-01-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1713109, encodeId=43991e13109c9, content=<a href='/topic/show?id=9a1c289680' target=_blank style='color:#2F92EE;'>#AST#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2896, encryptionId=9a1c289680, topicName=AST)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8b9831894722, createdName=ms24272190615788285182, createdTime=Wed Oct 19 19:05:03 CST 2022, time=2022-10-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1241633, encodeId=471f1241633a5, content=<a href='/topic/show?id=291a23643c2' target=_blank style='color:#2F92EE;'>#乳房重建#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=39, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=23643, encryptionId=291a23643c2, topicName=乳房重建)], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20220519/c2ab253484ee4527a2d4e9589a4821ac/45de9bf494a54becb2ea4369c9d11e85.jpg, createdBy=7a3710, createdName=循证小兵, createdTime=Sun Aug 28 15:32:32 CST 2022, time=2022-08-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1441733, encodeId=cce41441e3383, content=<a href='/topic/show?id=e24d561096c' target=_blank style='color:#2F92EE;'>#抽脂术#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=56109, encryptionId=e24d561096c, topicName=抽脂术)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=cf714881264, createdName=ms5106640509429053, createdTime=Thu Aug 18 15:05:03 CST 2022, time=2022-08-18, status=1, ipAttribution=)]
  2. [GetPortalCommentsPageByObjectIdResponse(id=2051835, encodeId=69a4205183559, content=<a href='/topic/show?id=95f8e042dd' target=_blank style='color:#2F92EE;'>#EST#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7042, encryptionId=95f8e042dd, topicName=EST)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e9a6357, createdName=xiangyuzhou971, createdTime=Sun Dec 18 12:05:03 CST 2022, time=2022-12-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1776238, encodeId=501d1e76238b3, content=<a href='/topic/show?id=95d3e9930fe' target=_blank style='color:#2F92EE;'>#美学#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=49, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79930, encryptionId=95d3e9930fe, topicName=美学)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a9de34, createdName=zhangpaul93, createdTime=Mon Jan 16 07:05:03 CST 2023, time=2023-01-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1713109, encodeId=43991e13109c9, content=<a href='/topic/show?id=9a1c289680' target=_blank style='color:#2F92EE;'>#AST#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2896, encryptionId=9a1c289680, topicName=AST)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8b9831894722, createdName=ms24272190615788285182, createdTime=Wed Oct 19 19:05:03 CST 2022, time=2022-10-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1241633, encodeId=471f1241633a5, content=<a href='/topic/show?id=291a23643c2' target=_blank style='color:#2F92EE;'>#乳房重建#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=39, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=23643, encryptionId=291a23643c2, topicName=乳房重建)], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20220519/c2ab253484ee4527a2d4e9589a4821ac/45de9bf494a54becb2ea4369c9d11e85.jpg, createdBy=7a3710, createdName=循证小兵, createdTime=Sun Aug 28 15:32:32 CST 2022, time=2022-08-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1441733, encodeId=cce41441e3383, content=<a href='/topic/show?id=e24d561096c' target=_blank style='color:#2F92EE;'>#抽脂术#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=56109, encryptionId=e24d561096c, topicName=抽脂术)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=cf714881264, createdName=ms5106640509429053, createdTime=Thu Aug 18 15:05:03 CST 2022, time=2022-08-18, status=1, ipAttribution=)]
  3. [GetPortalCommentsPageByObjectIdResponse(id=2051835, encodeId=69a4205183559, content=<a href='/topic/show?id=95f8e042dd' target=_blank style='color:#2F92EE;'>#EST#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7042, encryptionId=95f8e042dd, topicName=EST)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e9a6357, createdName=xiangyuzhou971, createdTime=Sun Dec 18 12:05:03 CST 2022, time=2022-12-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1776238, encodeId=501d1e76238b3, content=<a href='/topic/show?id=95d3e9930fe' target=_blank style='color:#2F92EE;'>#美学#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=49, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79930, encryptionId=95d3e9930fe, topicName=美学)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a9de34, createdName=zhangpaul93, createdTime=Mon Jan 16 07:05:03 CST 2023, time=2023-01-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1713109, encodeId=43991e13109c9, content=<a href='/topic/show?id=9a1c289680' target=_blank style='color:#2F92EE;'>#AST#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2896, encryptionId=9a1c289680, topicName=AST)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8b9831894722, createdName=ms24272190615788285182, createdTime=Wed Oct 19 19:05:03 CST 2022, time=2022-10-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1241633, encodeId=471f1241633a5, content=<a href='/topic/show?id=291a23643c2' target=_blank style='color:#2F92EE;'>#乳房重建#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=39, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=23643, encryptionId=291a23643c2, topicName=乳房重建)], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20220519/c2ab253484ee4527a2d4e9589a4821ac/45de9bf494a54becb2ea4369c9d11e85.jpg, createdBy=7a3710, createdName=循证小兵, createdTime=Sun Aug 28 15:32:32 CST 2022, time=2022-08-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1441733, encodeId=cce41441e3383, content=<a href='/topic/show?id=e24d561096c' target=_blank style='color:#2F92EE;'>#抽脂术#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=56109, encryptionId=e24d561096c, topicName=抽脂术)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=cf714881264, createdName=ms5106640509429053, createdTime=Thu Aug 18 15:05:03 CST 2022, time=2022-08-18, status=1, ipAttribution=)]
  4. [GetPortalCommentsPageByObjectIdResponse(id=2051835, encodeId=69a4205183559, content=<a href='/topic/show?id=95f8e042dd' target=_blank style='color:#2F92EE;'>#EST#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7042, encryptionId=95f8e042dd, topicName=EST)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e9a6357, createdName=xiangyuzhou971, createdTime=Sun Dec 18 12:05:03 CST 2022, time=2022-12-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1776238, encodeId=501d1e76238b3, content=<a href='/topic/show?id=95d3e9930fe' target=_blank style='color:#2F92EE;'>#美学#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=49, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79930, encryptionId=95d3e9930fe, topicName=美学)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a9de34, createdName=zhangpaul93, createdTime=Mon Jan 16 07:05:03 CST 2023, time=2023-01-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1713109, encodeId=43991e13109c9, content=<a href='/topic/show?id=9a1c289680' target=_blank style='color:#2F92EE;'>#AST#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2896, encryptionId=9a1c289680, topicName=AST)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8b9831894722, createdName=ms24272190615788285182, createdTime=Wed Oct 19 19:05:03 CST 2022, time=2022-10-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1241633, encodeId=471f1241633a5, content=<a href='/topic/show?id=291a23643c2' target=_blank style='color:#2F92EE;'>#乳房重建#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=39, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=23643, encryptionId=291a23643c2, topicName=乳房重建)], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20220519/c2ab253484ee4527a2d4e9589a4821ac/45de9bf494a54becb2ea4369c9d11e85.jpg, createdBy=7a3710, createdName=循证小兵, createdTime=Sun Aug 28 15:32:32 CST 2022, time=2022-08-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1441733, encodeId=cce41441e3383, content=<a href='/topic/show?id=e24d561096c' target=_blank style='color:#2F92EE;'>#抽脂术#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=56109, encryptionId=e24d561096c, topicName=抽脂术)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=cf714881264, createdName=ms5106640509429053, createdTime=Thu Aug 18 15:05:03 CST 2022, time=2022-08-18, status=1, ipAttribution=)]
  5. [GetPortalCommentsPageByObjectIdResponse(id=2051835, encodeId=69a4205183559, content=<a href='/topic/show?id=95f8e042dd' target=_blank style='color:#2F92EE;'>#EST#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7042, encryptionId=95f8e042dd, topicName=EST)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e9a6357, createdName=xiangyuzhou971, createdTime=Sun Dec 18 12:05:03 CST 2022, time=2022-12-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1776238, encodeId=501d1e76238b3, content=<a href='/topic/show?id=95d3e9930fe' target=_blank style='color:#2F92EE;'>#美学#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=49, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79930, encryptionId=95d3e9930fe, topicName=美学)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a9de34, createdName=zhangpaul93, createdTime=Mon Jan 16 07:05:03 CST 2023, time=2023-01-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1713109, encodeId=43991e13109c9, content=<a href='/topic/show?id=9a1c289680' target=_blank style='color:#2F92EE;'>#AST#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2896, encryptionId=9a1c289680, topicName=AST)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8b9831894722, createdName=ms24272190615788285182, createdTime=Wed Oct 19 19:05:03 CST 2022, time=2022-10-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1241633, encodeId=471f1241633a5, content=<a href='/topic/show?id=291a23643c2' target=_blank style='color:#2F92EE;'>#乳房重建#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=39, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=23643, encryptionId=291a23643c2, topicName=乳房重建)], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20220519/c2ab253484ee4527a2d4e9589a4821ac/45de9bf494a54becb2ea4369c9d11e85.jpg, createdBy=7a3710, createdName=循证小兵, createdTime=Sun Aug 28 15:32:32 CST 2022, time=2022-08-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1441733, encodeId=cce41441e3383, content=<a href='/topic/show?id=e24d561096c' target=_blank style='color:#2F92EE;'>#抽脂术#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=56109, encryptionId=e24d561096c, topicName=抽脂术)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=cf714881264, createdName=ms5106640509429053, createdTime=Thu Aug 18 15:05:03 CST 2022, time=2022-08-18, status=1, ipAttribution=)]

相关资讯

大容量吸脂术的安全性究竟如何?并发症发生率高吗?

抽脂是全球最受欢迎的美容外科手术之一,尽管已知并发症的风险会随着抽吸量的增加而增加,但“大容量吸脂术”的安全性及其并发症发生率此前尚未有系统描述。

多中心研究显示,这项TULUA腹部抽脂术效果美观,安全又可靠!

TULUA(横向折叠,无破坏性,完全吸脂,新脐成形术和腹部下横向瘢痕)是一种完全不同的腹部脂肪成形术的首字母缩写,旨在增加简单性,提高血管安全性,并获得良好效果。

快速安全又有效,不用抽脂也能拥有六块腹肌的午间整形术式!

虽说腹部抽脂可以增强肌肉轮廓,但抽脂是有创术式,本文分享了一种无创溶脂术式,并评估了这种术式的安全性和有效性。

大容量抽脂术会对术后代谢会造成什么影响呢?究竟是利是弊?

抽脂是全球最受欢迎的美容外科手术之一,据报道仅在美国 2019 年就进行了 270,670 次手术,自 2015 年以来增长了 6.5%,并且报告的 2018 年支出为 969,008,435 美元,

JAAD:连续3430例不同浓度利多卡因肿胀局麻吸脂效果观察

抽脂术是全世界最常见的整形外科手术之一。肿胀局部麻醉(TLA)技术的引入使手术过程发生了革命性的变化,使用400 mg/L的利多卡因生理盐水对大部分身体区域提供足够的麻醉.

10 年回顾性研究:多阶段吸脂术后患者报告的脂肪水肿相关症状改善

尽管外科手术治疗脂肪水肿的需求越来越大,但抽脂术的证据仍然有限。关于疾病分期、患者年龄、体重指数或现有共病对临床结果的影响知之甚少。