Vertical Reduction Mammaplasty with Medial Pedicle: A Reliable Method for Improving Breast Shape in Taiwanese Women

內側皮瓣垂直縮乳術：可靠改善台灣女性乳房外觀之整形手術

陸尊惠(Alice Tsun-Hui Lu) ； 楊奕志(Yi-Chih Yang) ； 黃繼增(Chi-Tseng Huang)

《臺灣整形外科醫學會雜誌》 20卷1期 (2011/03) Pp. 9-18

https://doi.org/10.7096/TJTSPS.201103.0009

摘要

背景：
縮乳手術治療乳房下垂及巨乳在西方文獻中早有多篇報告。目前最常使用的方法仍爲由下方皮瓣供給乳頭及乳暈之縮乳手術，但有越來越多的學者開始重視內側或上內側皮瓣。近年來巨乳及嚴重乳房下垂的台灣女性案例增多，但是在文獻中卻缺乏有關東方女性使用內側皮瓣合併垂直縮乳手術的結果及報告。
目標及主旨：
藉由病歷回溯及探討，報告我們針對接受內側皮瓣垂直縮乳手術的女性案例之結果。
材料及方法：
我們收集了2006年七月至2010年六月在國泰綜合醫院由兩位主治醫師進行的五例內側皮瓣垂直縮乳手術。藉由病例回顧及照片整理，我們報告案例之基本及手術相關資料，與術後結果及併發症。
結果：
病患於接受手術時之平均年齡爲26.8歲。平均身體質量指數爲22.95。每側乳房平均切除339.4克。平均手術時間244分鐘。五位病人中有一位因單側乳房肥大接受單側縮乳手術，其餘四位均接受兩側縮乳手術。最短追蹤時間爲2個月。
結論：
藉由內側皮瓣垂直縮乳手術，我們五例病患術後皆得到良好的乳房外觀。相較傳統的倒T字型縮乳術，病人術後疤痕少。病患沒有重大的術後併發症，並且長期追蹤的病患擁有較自然的乳房。我們相信此術式可以運用在乳房下垂、乳房肥大及乳房不對稱的台灣患者，達到一致、可靠的結果及美觀的乳房。

並列摘要

Background:
Reduction mammaplasty for the correction of the pendulous and hypertrophic breasts is an evolving technique that has received much spotlight in literature. Currently the most common procedure remains the inferior pedicle reduction mammaplasty, but an increasing number of authors are placing emphasis on the medial or superomedial pedicle. With a growing number of female patients in Taiwan seeking breast reduction due to heavy, ptotic breasts, we find that there is a lack of information in literature regarding vertical reduction mammaplasty with the medial pedicle in oriental women.
Aim and Objectives:
Through a retrospective review of patients who underwent medial pedicle vertical scar reduction mammaplasty, we report our results and evaluate their outcome.
Materials and Methods:
Five patients seeking reduction mammaplasty who received vertical scar with medial pedicle reduction at Cathay General Hospital between July 2006 and July 2010 were included in this study. All operations were performed by the two attending surgeon authors. A chart review was conducted and patient demographics, preoperative and postoperative photographs were recorded and evaluated. All complications were documented.
Results:
The average age was 26.8 years. Average body mass index was 22.95. The mean resection weight per breast was 339.4 g. The average operation time was 244 minutes. One patient had unilateral reduction mammaplasty due to unilateral breast hypertrophy. All four other patients received bilateral reduction mammaplasty. The minimum follow-up period was 2 months.
There were no cases of partial or complete nipple loss. One patient had postoperative seroma which resolved spontaneously with compressive dressing. One patient had hypertrophic vertical scars and received intralesional steroid injections (triamcinolone acetonide). Two patients had dog-ears at the inferior portion of the vertical scar during the early follow-up period. Skin contour smoothed out over time and no revisions were done. There were no cases of wound dehiscence, skin necrosis, hematoma, or infection.
Conclusion:
The vertical scar reduction mammaplasty performed in our series produced aesthetically pleasing breast shape with less scarring than the standard inverted-T or Wise pattern reductions in Taiwanese patients. There were no significant postoperative complications, and on follow-up, patients have more projected breasts without pseudoptosis or bottoming-out. We believe that this technique can be applied for a wide variety of patients to achieve consistent and reliable outcomes.

並列關鍵字

reduction mammaplasty ； oriental ； vertical scar ； medial pedicle ； vertical reduction ； breast reduction ； mammary hypertrophy