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Current aspects of therapeutic reduction mammaplasty for immediate early breast cancer management: An update

World Journal of Clinical Oncology 2014年第1期5卷 1-18页

作者： Alexandre Mendona Munhoz Eduardo Montag Rolf Gemperli Division of Plastic Surgery Hospital Sírio Libanês Sao Paulo 01239-040 Brazil Breast Reconstruction Group University of Sao Paulo School of Medicine Sao Paulo 01239-040 Brazil Department of Plastic Surgery University of Sao Paulo School of Medicine Sao Paulo 01239-040 Brazil

Breast-conservation surgery(BCS) is established as a safe surgical treatment for most patients with early breast cancer. Recently, advances in oncoplastic techniques are capable of preserving the breast form and quality of life. Although most BCS defects can be managed with primary closure, the aesthetic outcome may be unpredictable. Among technical options, therapeutic reduction mammaplasty(TRM) remains a useful procedure since the BCS defect can be repaired and the preoperative appearance can be improved, resulting in more proportional breasts. As a consequence of rich breast tissue vascularization, the greater part of reduction techniques have based their planning on preserving the pedicle of the nipple-areola complex after tumor removal. Reliable circulation and improvement of a conical shape to the breast are commonly described in TRM reconstructions. With an immediate approach, the surgical process is smooth since both procedures can be carried out in one operative setting. Additionally,it permits wider excision of the tumor, with a superior mean volume of the specimen and potentially reduces the incidence of margin involvement. Regardless of the fact that there is no consensus concerning the best TRM technique, the criteria is determined by the surgeon's experience, the extent/location of glandular tissue resection and the size of the defect in relation to the size of the remaining breast. The main advantages of the technique utilized should include reproducibility, low interference with the oncological treatment and long-term results. The success of the procedure depends on patient selection, coordinated planning and careful intra-operative management.

关键词： Breast reconstruction Conservative breast surgery Partial mastectomy Oncoplastic reduction mammaplasty Outcome Complications

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A New Technique for Mastopexy and reduction mammaplasty: The Rolling Bilateral Flap Technique

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Advances in Breast Cancer Research 2016年第2期5卷 74-82页

作者： Stefano A. Karoschitz Società Italiana di Chirurgia Plastica Ricostruttiva ed Estetica (SICPRE) Rome Italy

Background: Numerous techniques have been proposed as “gold standard” for mastopexy, as for reduction mammaplasty. The quality of the breast parenchyma should be a primary factor in selecting the most appropriate technique for an individual case. Objective: The article describes a simple technique that can be used either for mastopexy or for reduction mammaplasty, giving optimal breast shape and position. It is appropriate for patients having some degree of ptosis, and especially for those in whom the glandular component of the breast predominates. Methods: The technique entails elevating the entire dome of the breast, rolling it under, and then stitching the two halves of the breast parenchyma together (lateral and medial dermoglandular flaps), while the upper pedicle (a third dermoglandular flap) bearing the nipple areolar complex (NAC) severed from the two inferior flaps is attached as a cap. The result is a new and attractive shape of the underlying supporting “barrel”. The technique can be performed with the T scar or the vertical scar approach. Results: The procedure was applied for various indications on 45 patients aged 20 - 62 years. Good results were only achieved in 36 women with predominant glandular component. Nine patients with fatty breasts achieved unsatisfactory results (6 with T scar, 3 with vertical scar) and very poor breast projection. Conclusions: The best-suited candidates for the proposed technique for mastopexy or reduction mammaplasty are women in whom the glandular component of the breast predominates. This simple technique, applicable with either inverted T scar or vertical scar approaches, carries very low morbidity, affording an attractive profile, long-lasting results, and conserving the patient’s ability to breast feed.

关键词： Mastopexy reduction mammaplasty mammaplasty Inverted T Scar Vertical Scar Breast Autologous Prosthesis Gigantomastia Breast Asymmetry NAC Pedicle

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Safety,Efficacy and Modifications of Dermal-bra Technique for reduction mammaplasty and Ptosis Correction:A10-year Retrospective Study

Safety,Efficacy and Modifications of Dermal-bra Technique fo...

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2012全国中西医结合医学美容学术交流大会

作者：孙家明华中科技大学同济医学院附属协和医院整形外科湖北省整形外科学会中国医师协会整形美容分会武汉市整形外科学会《中华医学杂志》《中华临床医师杂志》《中国美容医学杂志》《组织工程和整形外科杂志》

Background:Dermal-bra technique was reported by us in 2003 for reduction mammaplasty and ptosis correction,thereafter,we had been summarizing and modifying continuously,and here we would like to share the experiences of modifications and analyze the long term safety and efficacy of this technique. Methods:347 patients received dermal-bra technique in our department from Oct. 2003 to Oct.2011,and 213 of them were successfully followed from 3m to 2y, patients before and after Oct.2006 were divided into early and late *** incidence of complications,long term satisfactory rate and developed modificationswere noted and analyzed. Results:Recent complications were presented in 55 breasts of 27 patients(7.9%), including hematoma(seroma),delayed wound healing,fat necrosis,deep folds, necrosis and numbness of nipple-areola complex(NAC).Long term complication were found in 28 breasts of 13 patients(6.6%),including widened scar & enlarged areola,irregular areola,secondary ptosis,sunken NAC,numbness of NAC,cyst andchronic *** one case of NAC numbness,all complications were successfully *** long term satisfactory rate was 95.7%.There were threemajor modifications:W or V shaped gland resection,medial rotation of gland flap and modified pursing *** these modifications,the recent and long term complication rates(preduction mammaplasty and ptosis correction.

关键词： dermal-bra technique reduction mammaplasty ptosis correction modification retrospective study

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