RU2116756C1 - Method for performing plastic reconstruction of mammary gland - Google Patents

Abstract

FIELD: medicine. SUBSTANCE: method involves cutting out two flaps from which the lower one is treated so that its skin is removed. The upper flap is cut out beginning from skin to musculus pectoralis major. The flap is divided into two parts having a single feeding limb. One of them is cutano-subcutaneous and the other one is rounded adipo-glandular one. Partial gland resection is carried out. The lower flap is placed between the parts of the upper one. EFFECT: improved operation result. 4 dwg

Description

 The invention relates to medicine, namely to plastic surgery, and can be used in reducing mammoplasty.

 A known method of breast plasty L. L. Pavlyuk-Pavlyuchenko [1].

 From the W-shaped incision, the upper skin-fatty flap is cut out, and the lower glandular-fatty flap with the nipple-areolar complex is dermalized, after which intermediate excess glands are excised in the form of a skin-parenchymatous segment, after which the lower flap is immersed under the upper one and the stitches are layered in layers.

 The main disadvantage of the prototype method is the presence in some cases of such a postoperative defect as retraction of the nipple.

 The essence of the invention lies in the fact that the upper flap is cut from the skin to the fascia of the pectoralis major muscle, and then it is divided into two parts having one nutritional leg: flat cutaneous-subcutaneous and round glandular-fatty. The lower adherentized flap is inserted between the parts of the upper, forming a new mammary gland.

 The result of the application of the proposed method is to improve the cosmetic effect of the operation, which consists in obtaining the mammary glands of the correct form with a convex nipple-areolar complex at the apex, excluding the retraction of the nipple.

 The implementation of the method is illustrated in the graphic material, where in FIG. 1 shows a marking of a skin incision; in FIG. 2 - upper and lower flaps; in FIG. 3 and 4 - splitting of the upper flap and a longitudinal section; in FIG. 5 and 6 - a new mammary gland and a longitudinal section are formed.

 The method is implemented as follows. After marking the cutting line (Fig. 1), a W-shaped line is obtained that defines the lower contours of the upper flap and a wave-like line that defines the upper contours of the lower flap, at the top of which there is a nipple-areolar complex with a periostatic circle of a new diameter. Next, the upper flap (Fig. 2a) is cut into the entire thickness of the gland and a thin lower flap with the nipple-areolar complex, including skin, subcutaneous tissue and gland tissue adjacent to the nipple-areolar complex. Adderiziruyut lower flap.

After cutting out the flaps, a fragmentary resection of the excess breast is performed. Next, the upper flap is split into 2 parts (Fig. 3), where a _{1 is the} cutaneous-fat part of the flap, a _{2 is} fat with elements of the gland parenchyma. A new mammary gland is formed, laying the lower flap in the cleavage of the upper between parts a ₁ and a ₂ . Layered stitches on the wound.

Example. Patient B., 45 years old, was admitted with complaints of large sizes and sagging of the mammary glands, pain in the cervical region, in the shoulder girdle from the severity of the mammary glands, diaper rash under the mammary glands. On examination, the mammary glands reach the level of the navel. Nipples 20 cm below the submammary folds, areoles expanded to 10 cm in diameter. The volume of the mammary glands is about 1000 cm ³ . The mammary gland palatability is painless, the lymph nodes are not enlarged.

 Ultrasound - the structure of the mammary glands without pathology.

 Dz Hypermastia, ptosis of mammary glands.

Reduction plastic of mammary glands was performed according to the method described above. The postoperative period without complications. The results of the operation are good. The shape of the mammary glands is correct. On top of the mammary glands, round-shaped nipples. Postoperative scars are smooth. Glands with a volume of about 400 cm ³ . The method was applied in 10 operations of reduction mammoplasty with a positive effect, which consisted in obtaining the mammary glands of the correct form with convex nipple-areolar complexes at the apex.

Claims (1)

 A method of breast plastic surgery, including cutting flaps with subsequent adherisation of the lower flap and resection of a part of the gland, characterized in that the upper flap is cut from the skin to the fascia of the pectoralis major muscle, and then it is divided into two parts - flat cutaneous-subcutaneous and round glandular-fat on one nutrient leg, after which a resection is made and the lower flap is inserted between the parts of the upper.

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