王一村,司婷婷,张敬德

[摘要]目的：探讨在改良真皮帽乳晕“米”字埋线法巨乳缩小术的临床应用，及术后埋线法的悬吊固定作用。方法：通过对17例患者34只乳房行改良真皮帽乳晕埋线法巨乳缩小术以及对患者线结活检标本进行病理学研究。结果：术后随访3～12个月，除1例裂开，1例乳头乳晕感觉丧失（经处理后均恢复），其余均一期愈合。埋线及其周围包膜可持续固定组织，调解组织松紧度，用作提升、牵引、收缩等效果持久理想。结论：改良真皮帽乳晕埋线法巨乳缩小术可简化手术过程、减少创伤、恢复快、疗效持久确实

[关键词]“米”字埋线法；巨乳；巨乳缩小术

[中图分类号]R622[文献标识码]A[文章编号]1008-6455（2012）04-0542-03

The application of the modified "米" style mammaplasty in breast reduction

WANG Yi-cun,SI Ting-ting, ZHANG Jing-de

(Department of Plastic Surgery,Affiliated Changhai Hospital of The Second Military Medical University,Shanghai 200433,China)

Abstract：Objective To discuss the clinical effect of the modified "米" style buried technipue mammaplasty and prove the lifting effect of the buried suture method. MethodsAnalysis the effects of 17 follow-up patients with the "米" style buried technipue mammaplasty, and study the pathology of the biopsy samples from the patients. Results All patients healed primarily except one was dehiscence and one was lost the sense(both healed after the therapy). The "米" style buried technipue and it's envelopes can fasten the tissue persistently, control the adjustment of tightness, make the effects perfectly of lifting, traction, constriction. Conclusion Using the modified "米" style buried technipue mammaplasty can simplify the surgery, reduce the complications, shorten the time of recovery, and make the fastened effects persistently.

Key words：modified "米" style buried technipue;macromastia;reduction mammaplasty

乳房肥大和下垂是女性常见乳房畸形。单侧体积大于400ml时称为肥大乳房， 当单侧体积超过1500ml时则称为巨大乳房[1]。不仅影响患者的形体美，而且由于持续的重力作用， 腹背侧力量不均衡，导致颈肩背部疼痛，长期作用可引起颈胸椎畸形变，乳房下湿疹、糜烂，给患者造成心理和生理上的巨大痛苦[2]。

巨乳缩小术及上提术式有很多种，双环法巨乳缩小术是目前较为完善的术式[3]，最大程度的减小了乳晕乳头坏死的可能性[4]，通过乳晕法缩小术省去了以往经典术式锚状（倒“T”）瘢痕中乳房下皱襞走形的横行瘢痕[5-8]。笔者在研读国外大量文献及手术方式后，在目前双环法巨乳缩小术的基础上进一步技术改良，使手术效果更加稳定。2008年1月～2011年1月，笔者采用改良真皮帽“米”字埋线法行巨乳缩小术17例，取得了满意的手术效果。……