RU2251980C1 - Method for correcting plasty of mammary gland - Google Patents

Abstract

FIELD: medicine, plastic surgery.

SUBSTANCE: one should perform mammary marking in the form of "keyhole" to cut mammary gland according to these marking lines at removing excessive tissue out of the inferior part of mammary gland followed by placing areola into new position. At cutting mammary gland along marking lines it is necessary to perform skin separation from mammary sections being under incision. Fatty fragment developed should be vertically divided into two parts: internal and external. Then external part should be turned under the gland and internal one should applied upon this turned under part of the fragment, direct it towards the upper pole under the skin of mammary gland to be fixed there. The innovation enables to approximate the shape of mammary gland being similar to natural one.

EFFECT: higher cosmetic result of plasty.

5 dwg, 1 ex

Description

The invention relates to medicine, in particular to surgery, and can be used to restore the shape of the mammary gland.

A known method of corrective plastic surgery of the mammary gland, including marking the new location of the halos and, accordingly, the cut out skin flap on the mammary gland, de-epithelialization of the skin within the pattern, moving the halos upwards with subsequent fixation of the skin around it, stitching the skin along marked lines, pulling it along horizontal and vertical, excision of excess skin in the lower chest, in the submammary fold, suturing, forming a scar in the form of an inverted letter T (Goulian D. Dermal masopexy. - P1. Rec. Surg., 1971, v. 47, p.105- 110). However, this method of correction of the mammary gland does not provide the desired cosmetic result, namely, slack remains in the upper pole of the mammary gland.

The closest technical solution to the proposed invention is a method of corrective plastic surgery of the mammary gland, which carry out the marking of the mammary gland. Around the halos draw a cut line in the form of a “keyhole”, the round part of which will be the new position of the halos. Then draw a line along the fold under the gland and connect with the vertical sides of the ″ well ″. During the operation, the skin is cut along these lines, the tissue from the lower part of the mammary gland is removed, and the halo is moved to a new position - up the ″ well ″. Two vertical incisions are sutured together and the incision is sutured in a submammary fold. We obtain the mammary gland of the desired shape and size (Encyclopedia of Plastic Surgery. Per Heden, Moscow 2001, pp. 190-191). The disadvantage of this method is that according to this method of corrective grafting, it is not always possible to provide the desired cosmetic result, namely, with sagging mammary glands, the upper pole of the mammary gland is not filled, and ugly depressions remain at the upper pole of the mammary gland after surgery.

The technical task of the invention is to improve the shape of the mammary gland, bringing it closer to its natural form, with obtaining a postoperative scar that is aesthetically satisfying in order to create a method of corrective plastic surgery of the mammary gland, providing a high cosmetic effect.

The stated technical problem is solved due to the fact that in the method of corrective surgery of the breast, including the marking of the breast, determining the new position of the halo, cutting the breast along these lines of marking with the removal of excess tissue from the lower part of the breast, placing the halo in a new position, stitching sections, while leaving a scar, when cutting the mammary gland along the marking lines, the skin is separated from the sections of the mammary gland below the section, the resulting fat flap is divided vertically in two parts - the outer and inner, then the outer part of the fat flap, sufficient to create the volume of the mammary gland under the halo, is turned under the gland, and the inner part of the fat flap, left sufficient to cover the outer part, is laid on top of the folded part of the flap, it is carried to the upper pole under the skin of the mammary gland and strengthen.

A distinctive feature of the proposed method from the prototype method is that when cutting out the mammary gland along the marking lines, the skin is separated from the sections of the mammary gland below the incision, the resulting fat flap is divided vertically into two parts - the outer and inner, then the outer part of the fat flap, sufficient for create volume in the central part of the mammary gland under the halo, tuck under the gland, and the inside of the fat flap left sufficient to cover the outside, t over the folded portion of the flap, it is carried to the upper pole of the breast and reinforce. It is such a placement of the fat flap under the skin of the gland with its further strengthening that helps to achieve a good cosmetic effect on the sagging mammary gland, namely, it becomes possible to get a breast shape that is close to natural, without retraction at the upper pole of the gland.

The accompanying drawings depict the sequence of actions in the implementation of the proposed method corrective surgery of the breast.

Figure 1 shows the marking of the operating areas on the mammary gland (marking is carried out in a standing position); figure 2 - cutting with separation of the skin from areas of the mammary gland below the incision, while dividing the fat flap into two sections; figure 3 - tucking the outer part of the fat flap inward under the gland in the form of a "snail"; figure 4 - the imposition of the inner part of the fat flap on top of a flap in the form of a "snail" flap, conducting it to the upper pole of the gland and fixing; figure 5 - stitching sections.

Figure 1-5 uses the following notation: 1 - mammary gland, 2 - halo, 3 - the boundaries of the cuts, 4 - fat flap, 4 - the outer part of the fat flap. 6 - the inner part of the fat flap, 7 - fixing threads, 8 - postoperative scar.

The method is as follows.

A thorough preoperative examination of the patient is preliminarily carried out. Immediately before the operation, the operating areas on the mammary gland are marked (Fig. 1) in the form of a “keyhole” 3. In this case, the patient is in a standing position. Then the patient is placed on the operating table in a supine position. Under general anesthesia, cutting is performed (Fig. 2), making incisions on the mammary gland along the borders of the incisions 3, separating the skin from sections of the mammary gland below the incision (Fig. 2), forming a fat flap 4. Halo 2 is transferred to a new position (Fig. 2) ) and hem to the skin. After that, the outer part 5 of the fatty flap, sufficient to create volume in the central part of the mammary gland under the halo, is wrapped under the skin of the mammary gland (Fig. 3) in the form of a “snail”, and the inner part of the fatty flap 6 is applied over the folded outer cochlearly folded flap 5 (figure 4), bring it under the skin of the upper pole of the mammary gland. It is stitched with threads 7 (Fig. 4), which are brought out in the upper pole of the gland. The final stage of the operation is the stitching of the incisions, forming a postoperative scar 8 of the shape of the inverted letter T (figure 5).

Example.

Patient P., 46 years old, was admitted to the clinic on October 22, 2001. Diagnosis: hypermastia.

On examination: a patient of moderate nutrition, height 178, weight 76 kg, large mammary glands, nipples reach the waist level, cyanosis of the tissue around the halo. The upper pole of the glands is practically not filled. When placing the finger in the crease under the chest between the fingers, only the skin. Before the operation, the mammary glands were marked around a halo of the ″ keyhole ”type, the round part of which is the new position of the halo, and the vertical sides are connected to the line along the fold under the breast. The sides are at an angle to the submammary fold, which determines the shape of the chest. The patient was in a standing position. Under general anesthesia, an operation was performed according to the proposed method. We made cuts along the planned lines. The halo was carefully separated from the underlying tissues and transferred to a new intended location. The skin was separated from the area of the mammary gland below the incisions, releasing a fatty flap. Next, a fatty flap was cut, dividing it lengthwise into two parts - external and internal. The outer part of the fat flap was dissected to a size sufficient to create a volume in the central part of the mammary gland under the halo, which was wrapped under the gland in the form of a “snail”, forming part of the mammary gland, and another part of the fat flap - the inside, was placed on top of it, leaving it is sufficient to shelter a tucked flap - ″ snail ″. The inner part of the fat flap was brought up the mammary gland, laying on the muscle under the skin of the upper pole of the mammary gland. The inner flap was stitched in advance at the end with threads. After laying this part of the fat flap and forming due to this upper pole of the mammary gland, the skin was pierced with needles and the threads were brought out, fixing them on the skin with a band-aid. Then the sections were stitched. First, two vertical incisions, and then an incision in the fold under the mammary gland, forming a scar in the form of an inverted letter T. They made an antiseptic sticker on the skin. The postoperative period without complications. Sutures were removed on the 12th day. The cosmetic effect is good.

Thus, the inventive method of corrective plastic surgery of the mammary gland allows to achieve an excellent cosmetic effect of the formed mammary gland.

Claims (1)

The corrective plasty of the sagging breast, including the marking of the breast in the form of a “keyhole”, the round part of which is the new position of the areola, and the vertical sides are connected to the line along the submammary fold, at an angle to it, cutting the breast along these marking lines with removal excess tissue from the lower part of the mammary gland, placing the areola in a new position, stitching the incisions, characterized in that when cutting the mammary gland along the marking lines, the skin is detached with of breast tissue below the incision, the resulting fat flap is divided vertically into two parts: the outer and inner, then the outer part of the fat flap, sufficient to create volume in the central part of the mammary gland under the areola, tucked under the gland, and the inner part of the fat flap left sufficient for shelters of the outer part, impose on top of the tucked part of the flap, carry it to the upper pole under the skin of the mammary gland and strengthen.

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